Kelly Bradford, is a medicare enrolled "Social Worker - Clinical" provider in Independence, Kansas. Her current practice location is
1101 Donald Ave, Independence, Kansas. You can reach out to her office (for appointments etc.) via phone at
(620) 331-1748.
Kelly Bradford is licensed to practice in Kansas (license number 4705) 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 1386906394.
Healthcare Provider's Profile
| Full Name | Kelly Bradford |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 1101 Donald Ave, Independence, Kansas |
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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: 1386906394
- Provider Enumeration Date: 06/14/2012
- Last Update Date: 08/28/2017
Medicare PECOS Information:
- PECOS PAC ID: 2769755057
- Enrollment ID: I20170908000209
Medical Identifiers
Medical identifiers for Kelly Bradford such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1386906394 | NPI | - | NPPES |
| 200875750A | Medicaid | KS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 995 (Kansas) | Secondary |
| 1041C0700X | Social Worker - Clinical | 4705 (Kansas) | 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. Kelly Bradford allows following entities to bill medicare on her behalf.
| Entity Name | Four County Mental Health Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1841290251
PECOS PAC ID: 7012904071
Enrollment ID: O20040430000887 |
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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. Kelly Bradford 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 Bradford,
Po Box 688,
Independence, KS 67301-0688
Ph: () - | Kelly Bradford,
1101 Donald Ave,
Independence, KS 67301-2001
Ph: (620) 331-1748 |
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