Mrs Kelly L King, PT is a medicare enrolled "Physical Therapist" provider in Camden, Tennessee. Her current practice location is
309 Highway 641 N, Camden, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(731) 584-1722.
Mrs Kelly L King is licensed to practice in Tennessee (license number PT0000007078) 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 1699709204.
Healthcare Provider's Profile
Full Name | Mrs Kelly L King |
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Gender | Female |
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Speciality | Physical Therapist |
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Location | 309 Highway 641 N, Camden, Tennessee |
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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: 1699709204
- Provider Enumeration Date: 07/10/2006
- Last Update Date: 08/12/2014
Medicare PECOS Information:
- PECOS PAC ID: 5991719684
- Enrollment ID: I20240326000481
Medical Identifiers
Medical identifiers for Mrs Kelly L King such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1699709204 | NPI | - | NPPES |
0446685 | Medicaid | TN | |
4117317 | Other | TN | BCBS PROVIDER NUMBER |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225100000X | Physical Therapist | PT0000007078 (Tennessee) | 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. Mrs Kelly L King allows following entities to bill medicare on her behalf.
Provider Name | Dynamix Physical Therapy Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
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Provider Identifiers | NPI Number: 1669619268 PECOS PAC ID: 5193873933 Enrollment ID: O20090504000677 |
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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. Mrs Kelly L King 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 Kelly L King, PT 309 Highway 641 N, Camden, TN 38320-3011 Ph: (731) 584-1722 | Mrs Kelly L King, PT 309 Highway 641 N, Camden, TN 38320-3011 Ph: (731) 584-1722 |
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