Dr Keshia Breanne Wagers, PHD is a medicare enrolled "Psychologist" provider in Manchester, Kentucky. Her current practice location is
56 Marie Langdon Dr, Manchester, Kentucky. You can reach out to her office (for appointments etc.) via phone at
(606) 598-4539.
Dr Keshia Breanne Wagers is licensed to practice in * (Not Available) (license number ) 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 1104496504.
Healthcare Provider's Profile
Full Name | Dr Keshia Breanne Wagers |
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Gender | Female |
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Speciality | Psychologist |
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Location | 56 Marie Langdon Dr, Manchester, Kentucky |
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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: 1104496504
- Provider Enumeration Date: 06/28/2021
- Last Update Date: 10/06/2021
Medicare PECOS Information:
- PECOS PAC ID: 4587055991
- Enrollment ID: I20211220000627
Medical Identifiers
Medical identifiers for Dr Keshia Breanne Wagers such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1104496504 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103T00000X | Psychologist | (* (Not Available)) | 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. Dr Keshia Breanne Wagers allows following entities to bill medicare on her behalf.
Entity Name | Memorial Hospital, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1831150119 PECOS PAC ID: 4486616141 Enrollment ID: O20041103001183 |
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Entity Name | Memorial Hospital, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1558665752 PECOS PAC ID: 4486616141 Enrollment ID: O20141202002193 |
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Entity Name | Memorial Hospital, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1255471827 PECOS PAC ID: 4486616141 Enrollment ID: O20141210002155 |
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Entity Name | Memorial Hospital, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1881112134 PECOS PAC ID: 4486616141 Enrollment ID: O20180529001421 |
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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. Dr Keshia Breanne Wagers 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 |
Dr Keshia Breanne Wagers, PHD 56 Marie Langdon Dr, Manchester, KY 40962-6329 Ph: () - | Dr Keshia Breanne Wagers, PHD 56 Marie Langdon Dr, Manchester, KY 40962-6329 Ph: (606) 598-4539 |
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