Luke Burkett Fondren, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Foley, Alabama. His current practice location is
1613 N Mckenzie St, Foley, Alabama. You can reach out to his office (for appointments etc.) via phone at
(251) 949-3400.
Luke Burkett Fondren is licensed to practice in Alabama (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1255837886.
Physician's Profile
| Full Name | Luke Burkett Fondren |
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| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 1613 N Mckenzie St, Foley, Alabama |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1255837886
- Provider Enumeration Date: 04/03/2018
- Last Update Date: 04/02/2020
Medicare PECOS Information:
- PECOS PAC ID: 7618388869
- Enrollment ID: I20201119003033
Medical Identifiers
Medical identifiers for Luke Burkett Fondren such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1255837886 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 208D00000X | General Practice | DO.2036 (Alabama) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (Alabama) | 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. Luke Burkett Fondren allows following entities to bill medicare on his behalf.
| Entity Name | Eastern Shore Urgent Care Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376706275 PECOS PAC ID: 1951464775 Enrollment ID: O20090106000100 |
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| Entity Name | Bhg Lxxii Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1699440149 PECOS PAC ID: 5597178244 Enrollment ID: O20210119002422 |
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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. Luke Burkett Fondren 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 |
Luke Burkett Fondren, DO 7856 Westside Park Dr Ste H, Mobile, AL 36695-8539 Ph: (251) 450-8151 | Luke Burkett Fondren, DO 1613 N Mckenzie St, Foley, AL 36535-2247 Ph: (251) 949-3400 |
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