Mrs Samantha Jayne Kelly, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Lincoln, Missouri. She graduated from nursing school in 2023 and has 2 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Bothwell Regional Health Center and her current practice location is
302 Us-65, Lincoln, Missouri. You can reach out to her office (for appointments etc.) via phone at
(660) 547-3915.
Mrs Samantha Jayne Kelly is licensed to practice in Missouri (license number 2023027198) 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 1740968080.
Provider's Profile
| Full Name | Mrs Samantha Jayne Kelly |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 2 Years |
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| Location | 302 Us-65, Lincoln, Missouri |
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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. |
Medical Education and Training:
- Mrs Samantha Jayne Kelly graduated from nursing school in 2023
NPI Data:
- NPI Number: 1740968080
- Provider Enumeration Date: 07/07/2023
- Last Update Date: 07/07/2023
Medicare PECOS Information:
- PECOS PAC ID: 3274993589
- Enrollment ID: I20230718004185
Medical Identifiers
Medical identifiers for Mrs Samantha Jayne Kelly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1740968080 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363LF0000X | Nurse Practitioner - Family | 2023027198 (Missouri) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| Bothwell Regional Health Center | 6103714126 | 106 |
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. Mrs Samantha Jayne Kelly allows following entities to bill medicare on her behalf.
| Entity Name | Bothwell Regional Health Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1235102690 PECOS PAC ID: 6103714126 Enrollment ID: O20040310000246 |
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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. Mrs Samantha Jayne Kelly 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 |
Mrs Samantha Jayne Kelly, FNP-C 31963 Hwy Ad, Cole Camp, MO 65325-2823 Ph: (660) 281-1006 | Mrs Samantha Jayne Kelly, FNP-C 302 Us-65, Lincoln, MO 65338-2012 Ph: (660) 547-3915 |
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