Kellie Michelle Hickerson, RN BSN MSN PMHNP-BC is a medicare enrolled "Clinical Nurse Specialist - Psychiatric/mental Health" in Beaver Dam, Kentucky. She graduated from nursing school in 2023 and has 3 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Ohio County Hospital Corporation and her current practice location is
1621 N Main St, Beaver Dam, Kentucky. You can reach out to her office (for appointments etc.) via phone at
(270) 274-9222.
Kellie Michelle Hickerson is licensed to practice in Kentucky (license number 4007496) 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 1538841382.
Provider's Profile
| Full Name | Kellie Michelle Hickerson |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 3 Years |
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| Location | 1621 N Main St, Beaver Dam, Kentucky |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kellie Michelle Hickerson graduated from nursing school in 2023
NPI Data:
- NPI Number: 1538841382
- Provider Enumeration Date: 08/02/2023
- Last Update Date: 08/02/2023
Medicare PECOS Information:
- PECOS PAC ID: 6608239835
- Enrollment ID: I20230905003844
Medical Identifiers
Medical identifiers for Kellie Michelle Hickerson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1538841382 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 364SP0808X | Clinical Nurse Specialist - Psychiatric/mental Health | 4007496 (Kentucky) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Ohio County Hospital Corporation | 3577477264 | 68 |
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. Kellie Michelle Hickerson allows following entities to bill medicare on her behalf.
| Entity Name | Ohio County Hospital Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1407049000
PECOS PAC ID: 3577477264
Enrollment ID: O20031117000774 |
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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. Kellie Michelle Hickerson 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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Kellie Michelle Hickerson, RN BSN MSN PMHNP-BC
126 Spinks Dr,
Hartford, KY 42347-9032
Ph: (270) 993-2767 | Kellie Michelle Hickerson, RN BSN MSN PMHNP-BC
1621 N Main St,
Beaver Dam, KY 42320-8963
Ph: (270) 274-9222 |
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