Nickole Anderson, is a medicare enrolled "Nurse Practitioner - Family" in Ellington, Missouri. Her current practice location is
61 Highway Y, Ellington, Missouri. You can reach out to her office (for appointments etc.) via phone at
(573) 663-2525.
Nickole Anderson is licensed to practice in Missouri (license number 2015037182) 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 1578936175.
Provider's Profile
Full Name | Nickole Anderson |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 61 Highway Y, Ellington, Missouri |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1578936175
- Provider Enumeration Date: 11/04/2015
- Last Update Date: 11/04/2015
Medicare PECOS Information:
- PECOS PAC ID: 5294045928
- Enrollment ID: I20151110001516
Medical Identifiers
Medical identifiers for Nickole Anderson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1578936175 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | 2015037182 (Missouri) | 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. Nickole Anderson allows following entities to bill medicare on her behalf.
Entity Name | Southeast Missouri Hospital Physicians Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1558311522 PECOS PAC ID: 9133024334 Enrollment ID: O20031201000775 |
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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. Nickole Anderson 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 |
Nickole Anderson, 61 Highway Y, Ellington, MO 63638-7802 Ph: () - | Nickole Anderson, 61 Highway Y, Ellington, MO 63638-7802 Ph: (573) 663-2525 |
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