Kendall M Mora, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Sharon, South Carolina. She graduated from nursing school in 2024 and has 1 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Broad River Wellness Llc and her current practice location is
4027 Woodlawn St, Sharon, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(803) 658-5058.
Kendall M Mora is licensed to practice in South Carolina (license number 28568) 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 1154171684.
Provider's Profile
| Full Name | Kendall M Mora |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 1 Years |
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| Location | 4027 Woodlawn St, Sharon, South Carolina |
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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:
- Kendall M Mora graduated from nursing school in 2024
NPI Data:
- NPI Number: 1154171684
- Provider Enumeration Date: 03/26/2024
- Last Update Date: 03/27/2024
Medicare PECOS Information:
- PECOS PAC ID: 1355885484
- Enrollment ID: I20240701001922
Medical Identifiers
Medical identifiers for Kendall M Mora such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1154171684 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 28568 (South Carolina) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Broad River Wellness Llc | 2567841281 | 3 |
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. Kendall M Mora allows following entities to bill medicare on her behalf.
| Entity Name | Broad River Wellness Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1992454532
PECOS PAC ID: 2567841281
Enrollment ID: O20220627000153 |
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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. Kendall M Mora 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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Kendall M Mora, FNP-C
4027 Woodlawn St,
Sharon, SC 29742-8779
Ph: (803) 448-8609 | Kendall M Mora, FNP-C
4027 Woodlawn St,
Sharon, SC 29742-8779
Ph: (803) 658-5058 |
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