Vicki Amanda Kelley, CRNP is a medicare enrolled "Nurse Practitioner - Family" in Ft Rucker, Alabama. Her current practice location is
301 Andrews Ave, Ft Rucker, Alabama. You can reach out to her office (for appointments etc.) via phone at
(334) 255-7747.
Vicki Amanda Kelley is licensed to practice in Alabama (license number 1-101347) 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 1093130791.
Provider's Profile
| Full Name | Vicki Amanda Kelley |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 301 Andrews Ave, Ft Rucker, Alabama |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1093130791
- Provider Enumeration Date: 03/04/2014
- Last Update Date: 05/12/2025
Medicare PECOS Information:
- PECOS PAC ID: 5294958203
- Enrollment ID: I20140520001972
Medical Identifiers
Medical identifiers for Vicki Amanda Kelley such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1093130791 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363LF0000X | Nurse Practitioner - Family | 1-101347 (Alabama) | 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. Vicki Amanda Kelley allows following entities to bill medicare on her behalf.
| Entity Name | Obstetrics & Gynecology Of Dothan Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1114021409 PECOS PAC ID: 9436051877 Enrollment ID: O20040124000415 |
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| Entity Name | Southern Alabama Physicians, Llp |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1467701490 PECOS PAC ID: 0345499562 Enrollment ID: O20121003000896 |
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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. Vicki Amanda Kelley 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 |
Vicki Amanda Kelley, CRNP 301 Andrews Ave, Ft Rucker, AL 36362 Ph: (334) 255-7747 | Vicki Amanda Kelley, CRNP 301 Andrews Ave, Ft Rucker, AL 36362 Ph: (334) 255-7747 |
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