Dr Shelly Holder Thompson, MD in Jacksonville, FL

Dr Shelly Holder Thompson, MD is a medicare enrolled "Pediatrics" physician in Jacksonville, Florida. Her current practice location is 120 King St, Jacksonville, Florida. You can reach out to her office (for appointments etc.) via phone at (904) 760-4904.

Dr Shelly Holder Thompson is licensed to practice in Florida (license number ME38917) 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 1821054560.

Contact Information

	Dr Shelly Holder Thompson, MD
	120 King St, Jacksonville, FL 32204-2410
	(904) 760-4904
	(904) 760-4250

Map and Direction

Physician's Profile

Full Name	Dr Shelly Holder Thompson
Gender	Female
Speciality	Pediatrics
Location	120 King St, Jacksonville, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1821054560
Provider Enumeration Date: 04/21/2006
Last Update Date: 07/21/2022

Medicare PECOS Information:

PECOS PAC ID: 6800937228
Enrollment ID: I20100107000595

Medical Identifiers

Medical identifiers for Dr Shelly Holder Thompson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1821054560	NPI	-	NPPES
066208900	Medicaid	FL
0662089-00	Medicaid	FL

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	ME0038917 (Florida)	Secondary
208000000X	Pediatrics	ME38917 (Florida)	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 Shelly Holder Thompson allows following entities to bill medicare on her behalf.

Entity Name	Agape Community Health Center, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1962867762 PECOS PAC ID: 3476500695 Enrollment ID: O20050331000177

Entity Name	Im Sulzbacher Center For The Homeless, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1710051354 PECOS PAC ID: 2860652641 Enrollment ID: O20130815000630

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 Shelly Holder Thompson 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 Shelly Holder Thompson, MD 120 King Street, Jacksonville, FL 32204-2410 Ph: (904) 760-4904	Dr Shelly Holder Thompson, MD 120 King St, Jacksonville, FL 32204-2410 Ph: (904) 760-4904

Reviews and Comments

Pediatrics Doctors in Jacksonville, FL

Dr. Maryam Ooja Abubakar, MD, MPH Pediatrics Medicare: Medicare Enrolled Practice Location: 655 W 8th St, Jacksonville, FL 32209 Phone: 904-244-3508
Dr. Mohamad Alasad Tolaymat, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 820 Prudential Dr, Ufjp Pediatric Multi-specialty Clinic, Jacksonville, FL 32207 Phone: 904-633-0920 Fax: 904-633-0921
Christopher Emanuel, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3945 San Jose Park Dr, Jacksonville, FL 32217 Phone: 904-731-3530 Fax: 904-737-1548
Bridget Sharrar, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 12276 San Jose Blvd Ste 507, Jacksonville, FL 32223 Phone: 904-288-8910 Fax: 904-288-8912
Kelly Marie Summers, ARNP Pediatrics Medicare: Medicare Enrolled Practice Location: 807 Childrens Way, Jacksonville, FL 32207 Phone: 904-697-3600
Yekaterina Jones, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 841 Prudential Dr Ste 1130, Jacksonville, FL 32207 Phone: 904-633-4199 Fax: 904-633-4188
Dr. Ronald P Carzoli Jr., MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1800 Barrs St, St Vincent's Medical Center, Jacksonville, FL 32204 Phone: 904-308-7994

Dr Shelly Holder Thompson, MD - Medicare Pediatrics in Jacksonville, FL