Ms Teresa J Nichols, LCSW is a medicare enrolled "Social Worker - Clinical" provider in New Madrid, Missouri. Her current practice location is
421 Line Street, New Madrid, Missouri. You can reach out to her office (for appointments etc.) via phone at
(573) 748-2592.
Ms Teresa J Nichols is licensed to practice in Missouri (license number 20002007253) 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 1003813957.
Healthcare Provider's Profile
| Full Name | Ms Teresa J Nichols |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 421 Line Street, New Madrid, Missouri |
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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: 1003813957
- Provider Enumeration Date: 07/07/2005
- Last Update Date: 04/20/2012
Medicare PECOS Information:
- PECOS PAC ID: 5092733873
- Enrollment ID: I20051110000167
Medical Identifiers
Medical identifiers for Ms Teresa J Nichols such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1003813957 | NPI | - | NPPES |
| 495072241 | Medicaid | MO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1041C0700X | Social Worker - Clinical | 20002007253 (Missouri) | 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 Teresa J Nichols allows following entities to bill medicare on her behalf.
| Entity Name | Saint Francis Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1356304489
PECOS PAC ID: 9931007929
Enrollment ID: O20040107000140 |
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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 Teresa J Nichols 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 Teresa J Nichols, LCSW
Po Box 128,
Blodgett, MO 63824-0128
Ph: (573) 703-6667 | Ms Teresa J Nichols, LCSW
421 Line Street,
New Madrid, MO 63869-1733
Ph: (573) 748-2592 |
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