Miss Jade Alexis Kelling, is a medicare enrolled "Nurse Practitioner - Family" physician in Watford City, North Dakota. Her current practice location is
340 N Main St Ste 311, Watford City, North Dakota. You can reach out to her office (for appointments etc.) via phone at
(701) 444-2888.
Miss Jade Alexis Kelling is licensed to practice in North Dakota (license number F08220262) 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 1366179509.
Physician's Profile
| Full Name | Miss Jade Alexis Kelling |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 340 N Main St Ste 311, Watford City, North Dakota |
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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: 1366179509
- Provider Enumeration Date: 08/08/2022
- Last Update Date: 03/08/2023
Medicare PECOS Information:
- PECOS PAC ID: 9234505090
- Enrollment ID: I20221019000874
Medical Identifiers
Medical identifiers for Miss Jade Alexis Kelling such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1366179509 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | F08220262 (North Dakota) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | R43520 (North Dakota) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | F08220262 (North Dakota) | 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. Miss Jade Alexis Kelling allows following entities to bill medicare on her behalf.
| Entity Name | Mckenzie County Healthcare Systems Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1063420495
PECOS PAC ID: 5890768006
Enrollment ID: O20040817000016 |
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| Entity Name | Anova Family Health Center Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1801145206
PECOS PAC ID: 4789837659
Enrollment ID: O20130102000163 |
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| Entity Name | Innovative Health |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1437859782
PECOS PAC ID: 2062872682
Enrollment ID: O20230714000707 |
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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. Miss Jade Alexis Kelling 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 |
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Miss Jade Alexis Kelling,
Po Box 1256,
Watford City, ND 58854-1256
Ph: (701) 444-2888 | Miss Jade Alexis Kelling,
340 N Main St Ste 311,
Watford City, ND 58854-7308
Ph: (701) 444-2888 |
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