Miss Kelly Nicole Giddens, MED CCC SLP is a medicare enrolled "Speech-language Pathologist" provider in Lula, Georgia. Her current practice location is
6220 Grove St, Lula, Georgia. You can reach out to her office (for appointments etc.) via phone at
(770) 653-1707.
Miss Kelly Nicole Giddens is licensed to practice in Georgia (license number 1373774) 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 1689130940.
Healthcare Provider's Profile
| Full Name | Miss Kelly Nicole Giddens |
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| Gender | Female |
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| Speciality | Speech-language Pathologist |
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| Location | 6220 Grove St, Lula, Georgia |
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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: 1689130940
- Provider Enumeration Date: 02/12/2019
- Last Update Date: 04/30/2025
Medicare PECOS Information:
- PECOS PAC ID: 8921525536
- Enrollment ID: I20250507002112
Medical Identifiers
Medical identifiers for Miss Kelly Nicole Giddens such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1689130940 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 235Z00000X | Speech-language Pathologist | 1373774 (Georgia) | 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. Miss Kelly Nicole Giddens allows following entities to bill medicare on her behalf.
| Provider Name | Legacy Healthcare Services Inc |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1528419751
PECOS PAC ID: 2163339722
Enrollment ID: O20160830000411 |
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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. Miss Kelly Nicole Giddens 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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Miss Kelly Nicole Giddens, MED CCC SLP
6220 Grove St,
Lula, GA 30554-2942
Ph: (770) 653-1707 | Miss Kelly Nicole Giddens, MED CCC SLP
6220 Grove St,
Lula, GA 30554-2942
Ph: (770) 653-1707 |
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