Shelly Y Gresham, RNC-FNP in Poplar Bluff, MO

Shelly Y Gresham, RNC-FNP is a medicare enrolled "Nurse Practitioner" in Poplar Bluff, Missouri. Her current practice location is 2480 Three Rivers Blvd, Poplar Bluff, Missouri. You can reach out to her office (for appointments etc.) via phone at (573) 686-5564.

Shelly Y Gresham is licensed to practice in Missouri (license number 126637) 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 1063491405.

Contact Information

	Shelly Y Gresham, RNC-FNP
	2480 Three Rivers Blvd, Poplar Bluff, MO 63901-2318
	(573) 686-5564
	(573) 686-2838

Map and Direction

Provider's Profile

Full Name	Shelly Y Gresham
Gender	Female
Speciality	Nurse Practitioner
Location	2480 Three Rivers Blvd, Poplar Bluff, Missouri
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1063491405
Provider Enumeration Date: 01/13/2006
Last Update Date: 09/22/2009

Medicare PECOS Information:

PECOS PAC ID: 1254236995
Enrollment ID: I20031223000646

Medical Identifiers

Medical identifiers for Shelly Y Gresham such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063491405	NPI	-	NPPES
428569842	Medicaid	MO

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	126637 (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. Shelly Y Gresham allows following entities to bill medicare on her behalf.

Entity Name	Icdoc, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1629756929 PECOS PAC ID: 7719363308 Enrollment ID: O20230711003862

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. Shelly Y Gresham 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
Shelly Y Gresham, RNC-FNP 2480 Three Rivers Blvd, Poplar Bluff, MO 63901-2318 Ph: (573) 686-5564	Shelly Y Gresham, RNC-FNP 2480 Three Rivers Blvd, Poplar Bluff, MO 63901-2318 Ph: (573) 686-5564

Reviews and Comments

Nurse Practitioner Nurses in Poplar Bluff, MO

Jamie Lynn Morse, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2588 N Westwood Blvd, Poplar Bluff, MO 63901 Phone: 573-778-1277 Fax: 573-778-1299
Alicia Marie Cisne, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 225 Physicians Park Ste 400, Poplar Bluff, MO 63901 Phone: 573-727-5500 Fax: 573-727-5599
Jessica Nicole Mccain, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2620 N Westwood Blvd, Poplar Bluff, MO 63901 Phone: 573-776-2835 Fax: 573-776-2763
Wanda R Shewmon, N.P. Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2210 Barron Rd, Poplar Bluff, MO 63901 Phone: 573-686-4133 Fax: 573-686-1315
Ms. Jolene M Wolf, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1500 N Westwood Blvd, Poplar Bluff, MO 63901 Phone: 573-686-4151
Rebecca Compton, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 225 Physicians Park Ste 400, Poplar Bluff, MO 63901 Phone: 573-727-5500 Fax: 573-727-5599

Shelly Y Gresham, RNC-FNP - Medicare Nurse Practitioner in Poplar Bluff, MO