Jacquiece Liddell, AGACNP in Ellenwood, GA - Medicare Nurse Practitioner

Jacquiece Liddell, AGACNP is a medicare enrolled "Nurse Practitioner - Acute Care" in Ellenwood, Georgia. She graduated from nursing school in 2015 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice The Emory Clinic, Inc and her current practice location is 4357 Boxwood Trl, Ellenwood, Georgia. You can reach out to her office (for appointments etc.) via phone at (678) 517-7897.

Jacquiece Liddell is licensed to practice in Georgia (license number RN206975) 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 1467988543.

Contact Information

	Jacquiece Liddell, AGACNP
	4357 Boxwood Trl, Ellenwood, GA 30294-6518
	(678) 517-7897
	Not Available

Map and Direction

Provider's Profile

Full Name	Jacquiece Liddell
Gender	Female
Speciality	Nurse Practitioner
Experience	9 Years
Location	4357 Boxwood Trl, Ellenwood, Georgia
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:

Jacquiece Liddell graduated from nursing school in 2015

NPI Data:

NPI Number: 1467988543
Provider Enumeration Date: 05/10/2017
Last Update Date: 05/10/2017

Medicare PECOS Information:

PECOS PAC ID: 5890031587
Enrollment ID: I20190117001499

Medical Identifiers

Medical identifiers for Jacquiece Liddell such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1467988543	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2100X	Nurse Practitioner - Acute Care	RN206975 (Georgia)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Emory Hillandale Hospital	Lithonia, GA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
The Emory Clinic, Inc	8820901408	2729

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. Jacquiece Liddell allows following entities to bill medicare on her behalf.

Entity Name	The Emory Clinic Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396798229 PECOS PAC ID: 8820901408 Enrollment ID: O20031110000503

Entity Name	Wellstar Medical Group, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374

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. Jacquiece Liddell 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
Jacquiece Liddell, AGACNP 4357 Boxwood Trail, Ellenwood, GA 30294 Ph: () -	Jacquiece Liddell, AGACNP 4357 Boxwood Trl, Ellenwood, GA 30294-6518 Ph: (678) 517-7897

Reviews and Comments

Nurse Practitioner Nurses in Ellenwood, GA

Sharalyn Marrion Martin, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 209 Saint Lukes Way, Ellenwood, GA 30294 Phone: 678-520-1616
Jacqueline Lewis, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 304 Summit Heights Ct Ste 120, Ellenwood, GA 30294 Phone: 404-552-5128
Ms. Abosede Haygood, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4639 River Hill Cir, Ellenwood, GA 30294 Phone: 404-259-0967
Ngassa Nchapada Menga Faith, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2568 Brittany Park Cv, Ellenwood, GA 30294 Phone: 404-578-5437
Rose Senge Kombe, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 211 Fairview Rd, Ellenwood, GA 30294 Phone: 678-289-6747 Fax: 678-289-6750
Mrs. Terrilyn D Lemons, APRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4018 Park Place Cir, Ellenwood, GA 30294 Phone: 404-212-1024 Fax: 404-212-1024
Ms. Kakethia S. Mack, NURSE PRACTITIONER Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4124 Bosenberry Way, Ellenwood, GA 30294 Phone: 678-463-6568 Fax: 678-463-6568

Jacquiece Liddell, AGACNP - Medicare Nurse Practitioner in Ellenwood, GA