Mrs Jessica Leigh Mack, ACNP is a medicare enrolled "Nurse Practitioner" physician in Winston Salem, North Carolina. She graduated from medical school in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Wake Forest University Health Sciences and her current practice location is
1 Medical Center Blvd, Winston Salem, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(336) 716-2011.
Mrs Jessica Leigh Mack is licensed to practice in North Carolina (license number 5012459) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1457994097.
Physician's Profile
Full Name | Mrs Jessica Leigh Mack |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Experience | 5 Years |
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Location | 1 Medical Center Blvd, Winston Salem, North Carolina |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Mrs Jessica Leigh Mack graduated from medical school in 2019
NPI Data:
- NPI Number: 1457994097
- Provider Enumeration Date: 10/27/2019
- Last Update Date: 10/29/2019
Medicare PECOS Information:
- PECOS PAC ID: 5698108389
- Enrollment ID: I20191211001047
Medical Identifiers
Medical identifiers for Mrs Jessica Leigh Mack such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1457994097 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207RC0200X | Internal Medicine - Critical Care Medicine | 254774 (North Carolina) | Secondary |
363LC0200X | Nurse Practitioner - Critical Care Medicine | 5012459 (North Carolina) | Secondary |
363L00000X | Nurse Practitioner | 5012459 (North Carolina) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Wake Forest University Health Sciences | 4486564952 | 2048 |
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. Mrs Jessica Leigh Mack allows following entities to bill medicare on her behalf.
Entity Name | Wake Forest University Health Sciences |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1003803032 PECOS PAC ID: 4486564952 Enrollment ID: O20031105000436 |
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Entity Name | Carolinas Medical Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1275774333 PECOS PAC ID: 4789597477 Enrollment ID: O20031110000116 |
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Entity Name | Novant Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1366409492 PECOS PAC ID: 1153234893 Enrollment ID: O20031121000692 |
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Entity Name | The Charlotte-mecklenburg Hospital Authority |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1669738829 PECOS PAC ID: 2961310685 Enrollment ID: O20100309000605 |
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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. Mrs Jessica Leigh Mack 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 |
Mrs Jessica Leigh Mack, ACNP 5515 Old Meadow Rd, Charlotte, NC 28227-2677 Ph: (828) 289-9211 | Mrs Jessica Leigh Mack, ACNP 1 Medical Center Blvd, Winston Salem, NC 27157-0001 Ph: (336) 716-2011 |
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