Kelly Costello Blackmon, APRN in Valdosta, GA

Kelly Costello Blackmon, APRN is a medicare enrolled "Nurse Practitioner - Acute Care" in Valdosta, Georgia. She graduated from nursing school in 2014 and has 10 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Bethany Hospice And Palliative Care, Llc, Sgmc Physician Network Inc and her current practice location is 2409 N. Patterson Street, Suite 230, Valdosta, Georgia. You can reach out to her office (for appointments etc.) via phone at (229) 259-4369.

Kelly Costello Blackmon is licensed to practice in Georgia (license number RN124057) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1992110688.

Contact Information

	Kelly Costello Blackmon, APRN
	2409 N. Patterson Street, Suite 230, Valdosta, GA 31602-2512
	(229) 259-4369
	(229) 433-6513

Map and Direction

Provider's Profile

Full Name	Kelly Costello Blackmon
Gender	Female
Speciality	Nurse Practitioner
Experience	10 Years
Location	2409 N. Patterson Street, Valdosta, Georgia
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Kelly Costello Blackmon graduated from nursing school in 2014

NPI Data:

NPI Number: 1992110688
Provider Enumeration Date: 06/22/2014
Last Update Date: 04/07/2015

Medicare PECOS Information:

PECOS PAC ID: 3072830058
Enrollment ID: I20150401001028

Medical Identifiers

Medical identifiers for Kelly Costello Blackmon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1992110688	NPI	-	NPPES
003154267A	Medicaid	GA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2100X	Nurse Practitioner - Acute Care	RN124057 (Georgia)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
South Georgia Medical Center	Valdosta, GA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Bethany Hospice And Palliative Care, Llc	1052409414	2
Sgmc Physician Network Inc	4082036843	107

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. Kelly Costello Blackmon allows following entities to bill medicare on her behalf.

Entity Name	Hospital Authority Of Valdosta And Lowndes County Georgia
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1033160791 PECOS PAC ID: 1355334509 Enrollment ID: O20040405001313

Entity Name	Bethany Hospice And Palliative Care, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1972709160 PECOS PAC ID: 1052409414 Enrollment ID: O20170428001358

Entity Name	Sgmc Physician Network Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1417597170 PECOS PAC ID: 4082036843 Enrollment ID: O20201015000629

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. Kelly Costello Blackmon 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
Kelly Costello Blackmon, APRN Po Box 0070, Valdosta, GA 31603-0070 Ph: (229) 259-4369	Kelly Costello Blackmon, APRN 2409 N. Patterson Street, Suite 230, Valdosta, GA 31602-2512 Ph: (229) 259-4369

Reviews and Comments

Nurse Practitioner Nurses in Valdosta, GA

John Stephen Dodd, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2501 N Patterson St, Valdosta, GA 31602 Phone: 229-259-4340 Fax: 259-259-4341
Vicki Wetter, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3120 N Oak Street Ext Ste G, Valdosta, GA 31602 Phone: 229-671-6130 Fax: 229-671-6764
Lindsey C Mcclain, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 117 W Northside Dr, Valdosta, GA 31602 Phone: 229-242-6061 Fax: 229-242-6151
Ms. Barbara Ann Pearce, ANP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4233 Camelot Xing, Valdosta, GA 31602 Phone: 229-469-4383 Fax: 229-469-4584
Mr. Nathan Kelly Roberson, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4340 Kings Way, Valdosta, GA 31602 Phone: 229-333-9736
Mr. Robert Donald Keen, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2602 Rolling Rd, Valdosta, GA 31602 Phone: 229-560-4575
William Thomas Mulligan Jr., FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2409 N Patterson St # F3, Valdosta, GA 31602 Phone: 229-433-8160

Kelly Costello Blackmon, APRN - Medicare Nurse Practitioner in Valdosta, GA