Mrs Vivian A Kelley, NP is a medicare enrolled "Chore Provider" in Fort Gordon, Georgia. Her current practice location is
300 W Hospital Road, Eisenhower Army Medical Center Attn Credentials, Fort Gordon, Georgia. You can reach out to her office (for appointments etc.) via phone at
(706) 787-2720.
Mrs Vivian A Kelley is licensed to practice in Alabama (license number 1-050977) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1669539094.
Provider's Profile
| Full Name | Mrs Vivian A Kelley |
|---|
| Gender | Female |
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| Speciality | Chore Provider |
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| Location | 300 W Hospital Road, Fort Gordon, Georgia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1669539094
- Provider Enumeration Date: 01/03/2007
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 7517005390
- Enrollment ID: I20091116000527
Medical Identifiers
Medical identifiers for Mrs Vivian A Kelley such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1669539094 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LF0000X | Nurse Practitioner - Family | RN159555 (Georgia) | Primary |
| 372500000X | Chore Provider | 1-050977 (Alabama) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Vivian A Kelley is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mrs Vivian A Kelley, NP
300 W. Hospital Road, Eisenhower Army Medical Center Attn Credentials,
Fort Gordon, GA 30905-5650
Ph: (706) 787-2720 | Mrs Vivian A Kelley, NP
300 W Hospital Road, Eisenhower Army Medical Center Attn Credentials,
Fort Gordon, GA 30905-5650
Ph: (706) 787-2720 |
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