Ms Maryalice Kelly, APN in Fayetteville, AR - Medicare Nurse Practitioner

Ms Maryalice Kelly, APN is a medicare enrolled "Nurse Practitioner" in Fayetteville, Arkansas. Her current practice location is 1125 N College Ave, Fayetteville, Arkansas. You can reach out to her office (for appointments etc.) via phone at (479) 713-8000.

Ms Maryalice Kelly is licensed to practice in Arkansas (license number A001933) 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 1326071283.

Contact Information

	Ms Maryalice Kelly, APN
	1125 N College Ave, Fayetteville, AR 72703-1908
	(479) 713-8000
	(479) 443-3903

Map and Direction

Provider's Profile

Full Name	Ms Maryalice Kelly
Gender	Female
Speciality	Nurse Practitioner
Location	1125 N College Ave, Fayetteville, Arkansas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1326071283
Provider Enumeration Date: 07/07/2006
Last Update Date: 04/07/2023

Medicare PECOS Information:

PECOS PAC ID: 3577572296
Enrollment ID: I20070116000184

Medical Identifiers

Medical identifiers for Ms Maryalice Kelly such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1326071283	NPI	-	NPPES
182728758	Medicaid	AR

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	A001933 (Arkansas)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Maryalice Kelly allows following entities to bill medicare on her behalf.

Entity Name	Northwest Physicians Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1194768721 PECOS PAC ID: 0244213213 Enrollment ID: O20040610000882

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. Ms Maryalice Kelly 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
Ms Maryalice Kelly, APN Po Box 251420, Little Rock, AR 72225-1420 Ph: (501) 686-8000	Ms Maryalice Kelly, APN 1125 N College Ave, Fayetteville, AR 72703-1908 Ph: (479) 713-8000

Reviews and Comments

Nurse Practitioner Nurses in Fayetteville, AR

Michele L Griffin, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1100 N College Ave, Fayetteville, AR 72703 Phone: 641-780-8696
Durinda Pena, A.P.N. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3232 N North Hills Blvd., Fayetteville, AR 72703 Phone: 479-587-1700 Fax: 479-587-1366
Mrs. Diane H. Morrow, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2630 E Citizens Dr Ste 13, Fayetteville, AR 72703 Phone: 479-571-6000
Colby Hines, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1100 N College Ave, Fayetteville, AR 72703 Phone: 479-443-4301
Elizabeth Ann-grace Burns, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3344 N Futrall Dr, Fayetteville, AR 72703 Phone: 479-521-8200 Fax: 479-582-7329
Julia Marsh, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 180 E Sunbridge Dr, Fayetteville, AR 72703 Phone: 479-587-5805 Fax: 479-659-7930
Miss Sarah Anne Campbell, DNP, AGAC-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3211 N Northhills Blvd, Fayetteville, AR 72703 Phone: 479-463-8740

Ms Maryalice Kelly, APN - Medicare Nurse Practitioner in Fayetteville, AR