Dr Shawna Blake Kirby, PHD is a medicare enrolled "Clinical Neuropsychologist" provider in West Columbia, South Carolina. Her current practice location is
1505 Charleston Hwy, # 1523, West Columbia, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(803) 497-3640.
Dr Shawna Blake Kirby is licensed to practice in South Carolina (license number 1251) 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 1174686356.
Healthcare Provider's Profile
| Full Name | Dr Shawna Blake Kirby |
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| Gender | Female |
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| Speciality | Clinical Neuropsychologist |
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| Location | 1505 Charleston Hwy, West Columbia, South Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1174686356
- Provider Enumeration Date: 12/18/2006
- Last Update Date: 02/28/2024
Medicare PECOS Information:
- PECOS PAC ID: 7719254036
- Enrollment ID: I20170517000533
Medical Identifiers
Medical identifiers for Dr Shawna Blake Kirby such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1174686356 | NPI | - | NPPES |
| PS0613 | Medicaid | SC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | 1251 (South Carolina) | Secondary |
| 103G00000X | Clinical Neuropsychologist | 1251 (South Carolina) | 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 Shawna Blake Kirby allows following entities to bill medicare on her behalf.
| Entity Name | Midlands Neurobehavioral Services, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1447709431
PECOS PAC ID: 6901173228
Enrollment ID: O20170517000279 |
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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 Shawna Blake Kirby 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 Shawna Blake Kirby, PHD
1505 Charleston Hwy, # 1523,
West Columbia, SC 29169-5069
Ph: (803) 995-1838 | Dr Shawna Blake Kirby, PHD
1505 Charleston Hwy, # 1523,
West Columbia, SC 29169-5069
Ph: (803) 497-3640 |
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