Dr Kelly Ennix King, MD is a medicare enrolled "Hospitalist" physician in Brandon, Florida. She went to University Of Tennessee, Hsc, College Of Medicine and graduated in 2001 and has 23 years of diverse experience with area of expertise as Internal Medicine. She is a member of the group practice Alameda Health System, Rural Physicians Group Pc and her current practice location is
935 Oakfield Dr, Brandon, Florida. You can reach out to her office (for appointments etc.) via phone at
(813) 651-3492.
Dr Kelly Ennix King is licensed to practice in California (license number A83650) 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 1114998606.
Physician's Profile
| Full Name | Dr Kelly Ennix King |
|---|
| Gender | Female |
|---|
| Speciality | Internal Medicine |
|---|
| Experience | 23 Years |
|---|
| Location | 935 Oakfield Dr, Brandon, Florida |
|---|
| 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:
- Dr Kelly Ennix King attended and graduated from University Of Tennessee, Hsc, College Of Medicine in 2001
NPI Data:
- NPI Number: 1114998606
- Provider Enumeration Date: 02/01/2006
- Last Update Date: 05/03/2023
Medicare PECOS Information:
- PECOS PAC ID: 1052488681
- Enrollment ID: I20110510000342
Medical Identifiers
Medical identifiers for Dr Kelly Ennix King such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1114998606 | NPI | - | NPPES |
| 009385100 | Medicaid | CA | |
| 009385100 | Medicaid | FL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | ME116572 (Florida) | Secondary |
| 207R00000X | Internal Medicine | A83650 (California) | Secondary |
| 208M00000X | Hospitalist | ME116572 (Florida) | Secondary |
| 208M00000X | Hospitalist | A83650 (California) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Alameda Health System | 3779494521 | 504 |
| Rural Physicians Group Pc | 2062767148 | 19 |
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. Dr Kelly Ennix King allows following entities to bill medicare on her behalf.
| Entity Name | Alameda Health System |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1740332931
PECOS PAC ID: 3779494521
Enrollment ID: O20031110000764 |
|---|
| Entity Name | Rural Physicians Group Pc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1730682394
PECOS PAC ID: 2062767148
Enrollment ID: O20180613000951 |
|---|
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. Dr Kelly Ennix King 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 |
|---|
Dr Kelly Ennix King, MD
11113 Coventry Grove Cir,
Lithia, FL 33547-4924
Ph: (813) 244-4741 | Dr Kelly Ennix King, MD
935 Oakfield Dr,
Brandon, FL 33511-4935
Ph: (813) 651-3492 |
Reviews and Comments