Jaqueline Dare Blackmon, PMHNP in Ruskin, FL - Medicare Nurse Practitioner

Jaqueline Dare Blackmon, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Ruskin, Florida. Her current practice location is 1610 Climbing Dayflower Dr, Ruskin, Florida. You can reach out to her office (for appointments etc.) via phone at (910) 584-0980.

Jaqueline Dare Blackmon is licensed to practice in Florida (license number 11024186) 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 1689370769.

Contact Information

	Jaqueline Dare Blackmon, PMHNP
	1610 Climbing Dayflower Dr, Ruskin, FL 33570-4949
	(910) 584-0980
	Not Available

Map and Direction

Provider's Profile

Full Name	Jaqueline Dare Blackmon
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	1610 Climbing Dayflower Dr, Ruskin, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1689370769
Provider Enumeration Date: 02/01/2023
Last Update Date: 02/01/2023

Medicare PECOS Information:

PECOS PAC ID: 3173980166
Enrollment ID: I20230607000286

Medical Identifiers

Medical identifiers for Jaqueline Dare Blackmon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1689370769	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	11024186 (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. Jaqueline Dare Blackmon allows following entities to bill medicare on her behalf.

Entity Name	Whitechapel Behavioral Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1245941343 PECOS PAC ID: 4486010097 Enrollment ID: O20230523002444

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. Jaqueline Dare Blackmon 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
Jaqueline Dare Blackmon, PMHNP 1610 Climbing Dayflower Dr, Ruskin, FL 33570-4949 Ph: (910) 584-0980	Jaqueline Dare Blackmon, PMHNP 1610 Climbing Dayflower Dr, Ruskin, FL 33570-4949 Ph: (910) 584-0980

Reviews and Comments

Nurse Practitioner Nurses in Ruskin, FL

Selena Crandall, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3860 Sun City Center Blvd, Ruskin, FL 33573 Phone: 813-633-1980 Fax: 813-355-5104
Nicole O'connor, AGPCNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 10113 Count Fleet Dr, Ruskin, FL 33573 Phone: 813-362-9588
Michelle Gordon Troyer, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 924 Cypress Village Blvd, Ruskin, FL 33573 Phone: 813-633-6121 Fax: 866-264-8519
Amorcita Madridondo Dougherty, A.R. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3040 E College Ave, Ruskin, FL 33570 Phone: 813-331-3940 Fax: 813-331-3941
Maricar C Cal, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2814 14th Ave Se, Ruskin, FL 33570 Phone: 813-361-1658
Devin Cedric Warfield, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1740 Bonita Bluff Ct, Ruskin, FL 33570 Phone: 904-861-5711
Jessica Spencer, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 9643 Lemon Drop Loop, Ruskin, FL 33573 Phone: 347-613-8658

Jaqueline Dare Blackmon, PMHNP - Medicare Nurse Practitioner in Ruskin, FL