Angela D Kennerly, FNP-C - Medicare Nurse Practitioner in Prairieville, LA

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Angela D Kennerly, FNP-C is a medicare enrolled "Nurse Practitioner - Family" physician in Prairieville, Louisiana. Her current practice location is 42079 Greenfield Xing, Prairieville, Louisiana. You can reach out to her office (for appointments etc.) via phone at (225) 278-9275.

Angela D Kennerly is licensed to practice in Louisiana (license number 229265) 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 1275249088.

Contact Information

Angela D Kennerly, FNP-C
42079 Greenfield Xing,
Prairieville, LA 70769-6045
(225) 278-9275
Not Available



Physician's Profile

Full NameAngela D Kennerly
GenderFemale
SpecialityNurse Practitioner - Family
Location42079 Greenfield Xing, Prairieville, Louisiana
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1275249088
  • Provider Enumeration Date: 01/25/2023
  • Last Update Date: 03/13/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 8527424001
  • Enrollment ID: I20230525003279

Medical Identifiers

Medical identifiers for Angela D Kennerly such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1275249088NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 229265 (Louisiana)Secondary
363LF0000XNurse Practitioner - Family 229265 (Louisiana)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. Angela D Kennerly allows following entities to bill medicare on her behalf.
Entity NameStat Care Clinics
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1467736165
PECOS PAC ID: 6103091624
Enrollment ID: O20111213000119

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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. Angela D Kennerly 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 AddressPractice Location Address
Angela D Kennerly, FNP-C
42079 Greenfield Xing,
Prairieville, LA 70769-6045

Ph: (225) 278-9275		Angela D Kennerly, FNP-C
42079 Greenfield Xing,
Prairieville, LA 70769-6045

Ph: (225) 278-9275

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