Jeanette Marie Jacobs, APRN is a medicare enrolled "Pediatrics" in Leitchfield, Kentucky. Her current practice location is
901 Wallace Ave, Leitchfield, Kentucky. You can reach out to her office (for appointments etc.) via phone at
(270) 259-5641.
Jeanette Marie Jacobs is licensed to practice in Kentucky (license number 3012495) 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 1912486887.
Provider's Profile
| Full Name | Jeanette Marie Jacobs |
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| Gender | Female |
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| Speciality | Pediatrics |
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| Location | 901 Wallace Ave, Leitchfield, Kentucky |
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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: 1912486887
- Provider Enumeration Date: 08/10/2018
- Last Update Date: 05/01/2019
Medicare PECOS Information:
- PECOS PAC ID: 3072847466
- Enrollment ID: I20190618002232
Medical Identifiers
Medical identifiers for Jeanette Marie Jacobs such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1912486887 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | 3012495 (Kentucky) | Secondary |
| 363LP0200X | Nurse Practitioner - Pediatrics | 3012495 (Kentucky) | Secondary |
| 208000000X | Pediatrics | 3012495 (Kentucky) | 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. Jeanette Marie Jacobs allows following entities to bill medicare on her behalf.
| Entity Name | Leitchfield Pediatric Clinic P.s.c. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1558318543
PECOS PAC ID: 9234187808
Enrollment ID: O20091117000437 |
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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. Jeanette Marie Jacobs 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 |
|---|
Jeanette Marie Jacobs, APRN
901 Wallace Ave,
Leitchfield, KY 42754-1417
Ph: (270) 259-5641 | Jeanette Marie Jacobs, APRN
901 Wallace Ave,
Leitchfield, KY 42754
Ph: (270) 259-5641 |
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