Heather Stafford, is a medicare enrolled "Nurse Practitioner" in Gainesboro, Tennessee. Her current practice location is
1340 N Grundy Quarles Hwy, Gainesboro, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(931) 268-0291.
Heather Stafford is licensed to practice in Tennessee (license number 35808) 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 1891551784.
Provider's Profile
| Full Name | Heather Stafford |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 1340 N Grundy Quarles Hwy, Gainesboro, Tennessee |
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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: 1891551784
- Provider Enumeration Date: 02/27/2024
- Last Update Date: 02/27/2024
Medicare PECOS Information:
- PECOS PAC ID: 1557707858
- Enrollment ID: I20240308002223
Medical Identifiers
Medical identifiers for Heather Stafford such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1891551784 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | 35808 (Tennessee) | 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. Heather Stafford allows following entities to bill medicare on her behalf.
| Entity Name | Ultra Health Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1922469543
PECOS PAC ID: 6800186602
Enrollment ID: O20160607002194 |
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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. Heather Stafford 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 |
|---|
Heather Stafford,
972 Haydenburg Rd,
Whitleyville, TN 38588-7059
Ph: () - | Heather Stafford,
1340 N Grundy Quarles Hwy,
Gainesboro, TN 38562-6001
Ph: (931) 268-0291 |
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