Kenna Courtney Stephanie Altobello, APN is a medicare enrolled "Clinical Nurse Specialist - Adult Health" in Lexington, South Carolina. Her current practice location is
104 Saluda Pointe Dr, Lexington, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(803) 296-7846.
Kenna Courtney Stephanie Altobello is licensed to practice in South Carolina (license number 18805) 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 1851716708.
Provider's Profile
| Full Name | Kenna Courtney Stephanie Altobello |
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| Gender | Female |
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| Speciality | Clinical Nurse Specialist - Adult Health |
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| Location | 104 Saluda Pointe Dr, Lexington, South Carolina |
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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: 1851716708
- Provider Enumeration Date: 03/03/2014
- Last Update Date: 06/01/2021
Medicare PECOS Information:
- PECOS PAC ID: 2163655580
- Enrollment ID: I20180116002351
Medical Identifiers
Medical identifiers for Kenna Courtney Stephanie Altobello such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1851716708 | NPI | - | NPPES |
| NP4873 | Medicaid | SC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163W00000X | Registered Nurse | 041323580 (Illinois) | Secondary |
| 364SA2200X | Clinical Nurse Specialist - Adult Health | 18805 (South Carolina) | 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. Kenna Courtney Stephanie Altobello allows following entities to bill medicare on her behalf.
| Entity Name | Prisma Health Medical Group-midlands |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1275988321
PECOS PAC ID: 5991099707
Enrollment ID: O20160802001226 |
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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. Kenna Courtney Stephanie Altobello 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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Kenna Courtney Stephanie Altobello, APN
Po Box 743904,
Atlanta, GA 30374-3904
Ph: (803) 296-7320 | Kenna Courtney Stephanie Altobello, APN
104 Saluda Pointe Dr,
Lexington, SC 29072-7295
Ph: (803) 296-7846 |
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