Kenneth S Gillespie, PA-C is a medicare enrolled "Physician Assistant" in Richwood, West Virginia. His current practice location is
75 Avenue B, Richwood, West Virginia. You can reach out to his office (for appointments etc.) via phone at
(304) 846-2573.
Kenneth S Gillespie is licensed to practice in West Virginia (license number 979) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1912952193.
Provider's Profile
| Full Name | Kenneth S Gillespie |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 75 Avenue B, Richwood, West Virginia |
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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: 1912952193
- Provider Enumeration Date: 05/24/2006
- Last Update Date: 11/22/2021
Medicare PECOS Information:
- PECOS PAC ID: 6103837331
- Enrollment ID: I20060531000254
Medical Identifiers
Medical identifiers for Kenneth S Gillespie such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1912952193 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | 979 (West Virginia) | Primary |
| 363A00000X | Physician Assistant | 2474-23 (Wisconsin) | Secondary |
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. Kenneth S Gillespie allows following entities to bill medicare on his behalf.
| Entity Name | Appalachian Mountains Medical LLC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1881023117
PECOS PAC ID: 6709016264
Enrollment ID: O20140228000564 |
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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. Kenneth S Gillespie 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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Kenneth S Gillespie, PA-C
Po Box 96,
Beaver, WV 25813-0096
Ph: (304) 763-5167 | Kenneth S Gillespie, PA-C
75 Avenue B,
Richwood, WV 26261-1236
Ph: (304) 846-2573 |
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