Nicole Angela Kelly-gordon, in Flagstaff, AZ - Medicare Social Worker Provider

Nicole Angela Kelly-gordon, is a medicare enrolled "Social Worker - Clinical" provider in Flagstaff, Arizona. Her current practice location is 2920 N 4th St, Flagstaff, Arizona. You can reach out to her office (for appointments etc.) via phone at (928) 853-2360.

Nicole Angela Kelly-gordon is licensed to practice in Arizona (license number LCSW-15933) 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 1851752224.

Contact Information

	Nicole Angela Kelly-gordon,
	2920 N 4th St, Flagstaff, AZ 86004-1816
	(928) 853-2360
	(928) 853-2360

Map and Direction

Healthcare Provider's Profile

Full Name	Nicole Angela Kelly-gordon
Gender	Female
Speciality	Social Worker - Clinical
Location	2920 N 4th St, Flagstaff, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1851752224
Provider Enumeration Date: 03/14/2016
Last Update Date: 04/20/2026

Medicare PECOS Information:

PECOS PAC ID: 2567769722
Enrollment ID: I20160401001907

Medical Identifiers

Medical identifiers for Nicole Angela Kelly-gordon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1851752224	NPI	-	NPPES
123528	Medicaid	AZ

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	LCSW-15933 (Arizona)	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. Nicole Angela Kelly-gordon allows following entities to bill medicare on her behalf.

Entity Name	North Country Healthcare Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073583472 PECOS PAC ID: 8820981053 Enrollment ID: O20040210001107

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. Nicole Angela Kelly-gordon 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
Nicole Angela Kelly-gordon, Po Box 1231, Tucson, AZ 85702-1231 Ph: (520) 670-3909	Nicole Angela Kelly-gordon, 2920 N 4th St, Flagstaff, AZ 86004-1816 Ph: (928) 853-2360

Reviews and Comments

Social Worker in Flagstaff, AZ

Mrs. Kathryn Louise Peterson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 115 E Birch Ave, Flagstaff, AZ 86001 Phone: 928-213-0068 Fax: 928-774-4367
Mrs. Tempest Smith, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2801 N Izabel St, Flagstaff, AZ 86004 Phone: 928-773-8200
Candace Stewart, MSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 2187 N Vickey St, Flagstaff, AZ 86004 Phone: 928-714-6401 Fax: 928-714-6480
Ms. Star Kelley, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2920 N 4th St, Flagstaff, AZ 86004 Phone: 928-522-9685
Molly Elizabeth Haak, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 320 N Leroux St Ste C, Flagstaff, AZ 86001 Phone: 289-864-7250
Hannah Bennett, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1500 E Cedar Ave Ste 26, Flagstaff, AZ 86004 Phone: 928-773-1245
Cherise Elizabeth Grimit Hovis, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6145 E Treadway Trl, Flagstaff, AZ 86004 Phone: 928-773-8270

Nicole Angela Kelly-gordon, - Medicare Clinical Social Worker in Flagstaff, AZ