Ms Lori Deprez King, RN, APNP is a medicare enrolled "Nurse Practitioner" in Kaukauna, Wisconsin. Her current practice location is
305 E 12th St, Kaukauna, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(920) 766-4656.
Ms Lori Deprez King is licensed to practice in Wisconsin (license number 423) 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 1548210925.
Provider's Profile
| Full Name | Ms Lori Deprez King |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 305 E 12th St, Kaukauna, Wisconsin |
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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: 1548210925
- Provider Enumeration Date: 05/10/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 8123157005
- Enrollment ID: I20100602000813
Medical Identifiers
Medical identifiers for Ms Lori Deprez King such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1548210925 | NPI | - | NPPES |
| 43819300 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | 423 (Wisconsin) | 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. Ms Lori Deprez King allows following entities to bill medicare on her behalf.
| Entity Name | Kaukauna Clinic, S.c. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1457317273
PECOS PAC ID: 5597765891
Enrollment ID: O20070111000068 |
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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. Ms Lori Deprez King 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 |
|---|
Ms Lori Deprez King, RN, APNP
305 E 12th St,
Kaukauna, WI 54130-2865
Ph: (920) 766-4656 | Ms Lori Deprez King, RN, APNP
305 E 12th St,
Kaukauna, WI 54130-2865
Ph: (920) 766-4656 |
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