Kelly Williams, in Alexandria, IN - Medicare Nurse Practitioner

Kelly Williams, is a medicare enrolled "Nurse Practitioner - Family" in Alexandria, Indiana. Her current practice location is 101 N Harrison St Ste A, Alexandria, Indiana. You can reach out to her office (for appointments etc.) via phone at (765) 233-0903.

Kelly Williams is licensed to practice in Indiana (license number 71012239A) 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 1417609231.

Contact Information

	Kelly Williams,
	101 N Harrison St Ste A, Alexandria, IN 46001-2017
	(765) 233-0903
	(765) 705-2141

Map and Direction

Provider's Profile

Full Name	Kelly Williams
Gender	Female
Speciality	Nurse Practitioner - Family
Location	101 N Harrison St Ste A, Alexandria, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1417609231
Provider Enumeration Date: 01/23/2022
Last Update Date: 09/24/2025

Medicare PECOS Information:

PECOS PAC ID: 6800338146
Enrollment ID: I20240603000976

Medical Identifiers

Medical identifiers for Kelly Williams such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1417609231	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	71012239A (Indiana)	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. Kelly Williams allows following entities to bill medicare on her behalf.

Entity Name	Cleanslate Medical Group Of Indiana Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1023464294 PECOS PAC ID: 4880963909 Enrollment ID: O20171023001515

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. Kelly Williams 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
Kelly Williams, 101 N Harrison St Ste A, Alexandria, IN 46001-2017 Ph: (765) 233-0903	Kelly Williams, 101 N Harrison St Ste A, Alexandria, IN 46001-2017 Ph: (765) 233-0903

Reviews and Comments

Nurse Practitioner Nurses in Alexandria, IN

Amanda R Tucker, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2012 S Park Ave, Alexandria, IN 46001 Phone: 765-724-6226
Jennifer Jean Howie, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2116 S Park Ave, Alexandria, IN 46001 Phone: 765-298-4000 Fax: 765-298-4013
Rhonda A Goforth, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2012 S Park Ave, Alexandria, IN 46001 Phone: 765-724-6226
Mrs. Shana Kaye Carmin, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2116 S Park Ave, Alexandria, IN 46001 Phone: 765-724-4455 Fax: 765-724-6247

Kelly Williams, - Medicare Nurse Practitioner in Alexandria, IN