Jordan Tyler Dewitt, MA, LMFT, LCAS is a medicare enrolled "Marriage & Family Therapist" provider in Ellerbe, North Carolina. His current practice location is
651 Jones Springs Church Rd, Ellerbe, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(910) 318-7416.
Jordan Tyler Dewitt is licensed to practice in North Carolina (license number 2160) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1679064984.
Healthcare Provider's Profile
Full Name | Jordan Tyler Dewitt |
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Gender | Male |
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Speciality | Marriage & Family Therapist |
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Location | 651 Jones Springs Church Rd, Ellerbe, North Carolina |
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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: 1679064984
- Provider Enumeration Date: 05/22/2018
- Last Update Date: 01/06/2022
Medicare PECOS Information:
- PECOS PAC ID: 7214472505
- Enrollment ID: I20240710005228
Medical Identifiers
Medical identifiers for Jordan Tyler Dewitt such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1679064984 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | LCAS-24343 (North Carolina) | Secondary |
106H00000X | Marriage & Family Therapist | 12093A (North Carolina) | Secondary |
106H00000X | Marriage & Family Therapist | 2160 (North Carolina) | 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. Jordan Tyler Dewitt allows following entities to bill medicare on his behalf.
Entity Name | Optum Behavioral Care Of North Carolina Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1629843933 PECOS PAC ID: 5092120030 Enrollment ID: O20210224002078 |
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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. Jordan Tyler Dewitt 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 |
Jordan Tyler Dewitt, MA, LMFT, LCAS 651 Jones Springs Church Rd, Ellerbe, NC 28338-8413 Ph: (910) 318-7416 | Jordan Tyler Dewitt, MA, LMFT, LCAS 651 Jones Springs Church Rd, Ellerbe, NC 28338-8413 Ph: (910) 318-7416 |
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