Jenna Brooke Pugh, FNP is a medicare enrolled "Nurse Practitioner - Family" in Carrollton, Mississippi. She graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Mallory Community Health and her current practice location is
2160 County Road 130, Carrollton, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(662) 299-5366.
Jenna Brooke Pugh is licensed to practice in Mississippi (license number 903532) and she also participates in the medicare program. She
may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1124660063.
Provider's Profile
| Full Name | Jenna Brooke Pugh |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 5 Years |
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| Location | 2160 County Road 130, Carrollton, Mississippi |
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| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Jenna Brooke Pugh graduated from nursing school in 2019
NPI Data:
- NPI Number: 1124660063
- Provider Enumeration Date: 10/11/2019
- Last Update Date: 10/11/2019
Medicare PECOS Information:
- PECOS PAC ID: 1254764830
- Enrollment ID: I20191212002109
Medical Identifiers
Medical identifiers for Jenna Brooke Pugh such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1124660063 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 903532 (Mississippi) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Mallory Community Health | 9739074501 | 11 |
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. Jenna Brooke Pugh allows following entities to bill medicare on her behalf.
| Entity Name | Mallory Community Health |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1740308873
PECOS PAC ID: 9739074501
Enrollment ID: O20040219000709 |
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| Entity Name | Fast Pace Mississippi Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1447769559
PECOS PAC ID: 3678832029
Enrollment ID: O20180111000291 |
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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. Jenna Brooke Pugh 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 |
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Jenna Brooke Pugh, FNP
2160 County Road 130,
Carrollton, MS 38917-5731
Ph: () - | Jenna Brooke Pugh, FNP
2160 County Road 130,
Carrollton, MS 38917-5731
Ph: (662) 299-5366 |
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