Kimberly S Squires, FNP-C; PMHNP-BC in Charlotte, NC

Kimberly S Squires, FNP-C; PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Charlotte, North Carolina. Her current practice location is 10320 Mallard Creek Rd, Ste 240, Charlotte, North Carolina. You can reach out to her office (for appointments etc.) via phone at (704) 886-8703.

Kimberly S Squires is licensed to practice in North Carolina (license number 2014029878) 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 1871735068.

Contact Information

	Kimberly S Squires, FNP-C; PMHNP-BC
	10320 Mallard Creek Rd, Ste 240, Charlotte, NC 28262-9756
	(704) 886-8703
	Not Available

Map and Direction

Provider's Profile

Full Name	Kimberly S Squires
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	10320 Mallard Creek Rd, Charlotte, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1871735068
Provider Enumeration Date: 04/02/2009
Last Update Date: 07/22/2016

Medicare PECOS Information:

PECOS PAC ID: 8820141427
Enrollment ID: I20101116000636

Medical Identifiers

Medical identifiers for Kimberly S Squires such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1871735068	NPI	-	NPPES
5004974	Other	NC	ETN P97980

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	2008001301 (North Carolina)	Secondary
363L00000X	Nurse Practitioner	218478 (North Carolina)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	2014029878 (North 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. Kimberly S Squires allows following entities to bill medicare on her behalf.

Entity Name	Monarch
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1801116405 PECOS PAC ID: 0244273852 Enrollment ID: O20050728000103

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. Kimberly S Squires 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
Kimberly S Squires, FNP-C; PMHNP-BC 10320 Mallard Creek Rd, Ste 240, Charlotte, NC 28262-9756 Ph: (704) 886-8703	Kimberly S Squires, FNP-C; PMHNP-BC 10320 Mallard Creek Rd, Ste 240, Charlotte, NC 28262-9756 Ph: (704) 886-8703

Reviews and Comments

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Kimberly S Squires, FNP-C; PMHNP-BC - Medicare Nurse Practitioner in Charlotte, NC