Brandy Divine, FNP - Medicare Nurse Practitioner in Kirksville, MO

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Brandy Divine, FNP is a medicare enrolled "Nurse Practitioner - Family" in Kirksville, Missouri. Her current practice location is 900 E Laharpe St, Kirksville, Missouri. You can reach out to her office (for appointments etc.) via phone at (660) 665-1962.

Brandy Divine is licensed to practice in Missouri (license number 2016037534) 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 1457803363.

Contact Information

Brandy Divine, FNP
900 E Laharpe St,
Kirksville, MO 63501-4520
(660) 665-1962
Not Available

Map and Direction




Provider's Profile

Full NameBrandy Divine
GenderFemale
SpecialityNurse Practitioner - Family
Location900 E Laharpe St, Kirksville, Missouri
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1457803363
  • Provider Enumeration Date: 10/26/2016
  • Last Update Date: 07/01/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 8527347772
  • Enrollment ID: I20161111000685

Medical Identifiers

Medical identifiers for Brandy Divine such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1457803363NPI-NPPES
1457803363MedicaidMO

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 2016037534 (Missouri)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. Brandy Divine allows following entities to bill medicare on her behalf.
Entity NameInfinite Medical Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1407483175
PECOS PAC ID: 8325477656
Enrollment ID: O20230319000053
Entity NameDivine Redemption Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1790536142
PECOS PAC ID: 0446793582
Enrollment ID: O20240618002076
Entity NameTheoria Medical
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1609362375
PECOS PAC ID: 5395098339
Enrollment ID: O20240919002593
Entity NameMedical Director Services Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1871955807
PECOS PAC ID: 0042501116
Enrollment ID: O20241029001887
Entity NameJds Medical Services Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1174224653
PECOS PAC ID: 2062948748
Enrollment ID: O20241204002860
Entity NameProvider Partners Care Management Lp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1013348028
PECOS PAC ID: 9335379270
Enrollment ID: O20250214001888

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. Brandy Divine 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 AddressPractice Location Address
Brandy Divine, FNP
1601 Old South River Rd,
Saint Charles, MO 63303-4120

Ph: (636) 224-1210		Brandy Divine, FNP
900 E Laharpe St,
Kirksville, MO 63501-4520

Ph: (660) 665-1962

Reviews and Comments


Nurse Practitioner Nurses in Kirksville, MO

Amanda Sevits, FNP-C
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 1611 S Baltimore St, Kirksville, MO 63501
Phone: 660-665-7575    
Brooke April Sprague, FNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1611 S Baltimore St, Kirksville, MO 63501
Phone: 660-665-7575    Fax: 660-665-7576
Rachel Catherine Selby, AGACNP-BC
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 800 W Jefferson St, Kirksville, MO 63501
Phone: 660-956-4392    
Whitney Jean Roller, MSN, FNP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1611 S Baltimore St, Kirksville, MO 63501
Phone: 660-665-7575    
Kathy Ayers, F.N.P.
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 800 W Jefferson St, Kirksville, MO 63501
Phone: 662-626-2235    Fax: 660-626-2090
Teresa Lyn Tucker, RN, WHNP-BC
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 100 E Normal Ave, Kirksville, MO 63501
Phone: 660-785-4182    
Cassie Marie Tilton, NP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1506 Crown Dr, Kirksville, MO 63501
Phone: 660-627-4493    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.