Jacqueline Louise Wellborn, is a medicare enrolled "Nurse Practitioner - Family" in Hico, Texas. Her current practice location is
104 S Walnut St, Hico, Texas. You can reach out to her office (for appointments etc.) via phone at
(254) 796-4224.
Jacqueline Louise Wellborn is licensed to practice in Texas (license number 2021118463) 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 1871258152.
Provider's Profile
Full Name | Jacqueline Louise Wellborn |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 104 S Walnut St, Hico, Texas |
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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: 1871258152
- Provider Enumeration Date: 11/02/2021
- Last Update Date: 08/14/2023
Medicare PECOS Information:
- PECOS PAC ID: 3870985765
- Enrollment ID: I20220127000295
Medical Identifiers
Medical identifiers for Jacqueline Louise Wellborn such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1871258152 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | 883588 (Texas) | Secondary |
363LF0000X | Nurse Practitioner - Family | 2021118463 (Texas) | 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. Jacqueline Louise Wellborn allows following entities to bill medicare on her behalf.
Entity Name | Hamilton County Hospital District |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1326037607 PECOS PAC ID: 2062326234 Enrollment ID: O20031113000242 |
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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. Jacqueline Louise Wellborn 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 |
Jacqueline Louise Wellborn, 400 N Brown St, Hamilton, TX 76531-1518 Ph: (254) 386-1895 | Jacqueline Louise Wellborn, 104 S Walnut St, Hico, TX 76457 Ph: (254) 796-4224 |
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