Dr Jacqueline Countryman, MD in Dayton, OH - Medicare Psychiatry & Neurology

Dr Jacqueline Countryman, MD is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Dayton, Ohio. Her current practice location is 601 S Edwin C Moses Blvd, East Building, 4th Floor, Dayton, Ohio. You can reach out to her office (for appointments etc.) via phone at (937) 276-8333.

Dr Jacqueline Countryman is licensed to practice in Ohio (license number 35-07-3384-C) 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 1396802096.

Contact Information

	Dr Jacqueline Countryman, MD
	601 S Edwin C Moses Blvd, East Building, 4th Floor, Dayton, OH 45408-1424
	(937) 276-8333
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Jacqueline Countryman
Gender	Female
Speciality	Psychiatry & Neurology - Psychiatry
Location	601 S Edwin C Moses Blvd, Dayton, Ohio
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1396802096
Provider Enumeration Date: 01/02/2007
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 4183681919
Enrollment ID: I20150203001795

Medical Identifiers

Medical identifiers for Dr Jacqueline Countryman such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1396802096	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2084P0800X	Psychiatry & Neurology - Psychiatry	35-07-3384-C (Ohio)	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. Dr Jacqueline Countryman allows following entities to bill medicare on her behalf.

Entity Name	Coleman Professional Services, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1982637633 PECOS PAC ID: 2769474618 Enrollment ID: O20040331001085

Entity Name	Psychological & Behavioral Consultants Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1811915713 PECOS PAC ID: 0446243760 Enrollment ID: O20040405000363

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. Dr Jacqueline Countryman 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
Dr Jacqueline Countryman, MD 601 S Edwin C Moses Blvd, East Building, 4th Floor, Dayton, OH 45408-1424 Ph: (937) 276-8333	Dr Jacqueline Countryman, MD 601 S Edwin C Moses Blvd, East Building, 4th Floor, Dayton, OH 45408-1424 Ph: (937) 276-8333

Reviews and Comments

Psychiatry & Neurology Doctors in Dayton, OH

Dr. Katherine Mchugh Winner, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1 Childrens Plz, Dayton, OH 45404 Phone: 937-641-4040 Fax: 937-641-3066
Dr. Mary S Feldman, DO Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 30 E Apple St Ste 5254a, Dayton, OH 45409 Phone: 937-208-4200 Fax: 937-208-4205
Jerome John Schulte Jr., MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 2200 Philadelphia Dr, Suite 4505, Dayton, OH 45406 Phone: 937-734-2446 Fax: 937-734-4219
Jerald Kay, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 627 Edwin C Moses Blvd, East Medical Plaza, Dayton, OH 45408 Phone: 937-223-8840 Fax: 937-223-0758
Dr. Amarjeet S Birdi, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 627 S Edwin C Moses Blvd, Suite G, Dayton, OH 45417 Phone: 937-424-1000 Fax: 937-424-1002
Susan Kay Songer, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 3095 Kettering Blvd, Dayton, OH 45439 Phone: 937-293-8300
Dr. Pavan Somusetty, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 2222 Philadelphia Dr, Dayton, OH 45406 Phone: 937-278-2612

Dr Jacqueline Countryman, MD - Medicare Psychiatry & Neurology in Dayton, OH