Kellie Michelle Hickerson, RN BSN MSN PMHNP-BC - Medicare Clinical Nurse Specialist in Beaver Dam, KY

Kellie Michelle Hickerson, RN BSN MSN PMHNP-BC is a medicare enrolled "Clinical Nurse Specialist - Psychiatric/mental Health" in Beaver Dam, Kentucky. Her current practice location is 1621 N Main St, Beaver Dam, Kentucky. You can reach out to her office (for appointments etc.) via phone at (270) 274-9222.

Kellie Michelle Hickerson is licensed to practice in Kentucky (license number 4007496) 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 1538841382.

Contact Information

Kellie Michelle Hickerson, RN BSN MSN PMHNP-BC
1621 N Main St,
Beaver Dam, KY 42320-8963
(270) 274-9222
Not Available



Provider's Profile

Full NameKellie Michelle Hickerson
GenderFemale
SpecialityClinical Nurse Specialist - Psychiatric/mental Health
Location1621 N Main St, Beaver Dam, Kentucky
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1538841382
  • Provider Enumeration Date: 08/02/2023
  • Last Update Date: 08/02/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 6608239835
  • Enrollment ID: I20230905003844

Medical Identifiers

Medical identifiers for Kellie Michelle Hickerson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1538841382NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
364SP0808XClinical Nurse Specialist - Psychiatric/mental Health 4007496 (Kentucky)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. Kellie Michelle Hickerson allows following entities to bill medicare on her behalf.
Entity NameOhio County Hospital Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1407049000
PECOS PAC ID: 3577477264
Enrollment ID: O20031117000774

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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. Kellie Michelle Hickerson 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
Kellie Michelle Hickerson, RN BSN MSN PMHNP-BC
126 Spinks Dr,
Hartford, KY 42347-9032

Ph: (270) 993-2767
Kellie Michelle Hickerson, RN BSN MSN PMHNP-BC
1621 N Main St,
Beaver Dam, KY 42320-8963

Ph: (270) 274-9222

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Clinical Nurse Specialist Nurses in Beaver Dam, KY


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