Jennifer Ann Shade, - Medicare Nurse Practitioner in Kingman, AZ

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Jennifer Ann Shade, is a medicare enrolled "Nurse Practitioner - Primary Care" in Kingman, Arizona. 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 Kingman Healthcare Inc and her current practice location is 1740 E Beverly Ave Ste B, Kingman, Arizona. You can reach out to her office (for appointments etc.) via phone at (928) 263-1335.

Jennifer Ann Shade is licensed to practice in Arizona (license number RN164008) 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 1922645696.

Contact Information

Jennifer Ann Shade,
1740 E Beverly Ave Ste B,
Kingman, AZ 86409-3564
(928) 263-1335
(928) 272-0173

Map and Direction




Provider's Profile

Full NameJennifer Ann Shade
GenderFemale
SpecialityNurse Practitioner
Experience5 Years
Location1740 E Beverly Ave Ste B, Kingman, Arizona
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jennifer Ann Shade graduated from nursing school in 2019
  NPI Data:
  • NPI Number: 1922645696
  • Provider Enumeration Date: 12/02/2019
  • Last Update Date: 03/16/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 7911334222
  • Enrollment ID: I20200226002601

Medical Identifiers

Medical identifiers for Jennifer Ann Shade such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1922645696NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP2300XNurse Practitioner - Primary Care RN164008 (Arizona)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Kingman Regional Medical CenterKingman, AZHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Kingman Healthcare Inc6901791367170

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. Jennifer Ann Shade allows following entities to bill medicare on her behalf.
Entity NameKingman Healthcare Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1265423917
PECOS PAC ID: 6901791367
Enrollment ID: O20040216001173
Entity NameExceptional Physicians Group Bullhead City Hospital Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1518732023
PECOS PAC ID: 9335599604
Enrollment ID: O20231228002414

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. Jennifer Ann Shade 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 AddressPractice Location Address
Jennifer Ann Shade,
1740 E Beverly Ave Ste B,
Kingman, AZ 86409-3564

Ph: (928) 263-1335		Jennifer Ann Shade,
1740 E Beverly Ave Ste B,
Kingman, AZ 86409-3564

Ph: (928) 263-1335

Reviews and Comments


Nurse Practitioner Nurses in Kingman, AZ

Steven Korona, MSN, RN, PMHNP
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Medicare: Accepting Medicare Assignments
Practice Location: 3505 Western Ave, Kingman, AZ 86409
Phone: 928-757-8111    Fax: 928-757-1199
Michelle Fletcher, NP-C
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Practice Location: 2226 Hualapai Mountain Rd Ste 100, Kingman, AZ 86401
Phone: 928-681-8530    
Berenice Jeacel Espinoza, FNP, RN
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Practice Location: 3555 Western Ave, Kingman, AZ 86409
Phone: 888-209-8874    
Rachel Rae Delfino Briles, FNP-C
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Medicare: Accepting Medicare Assignments
Practice Location: 1739 E Beverly Ave Ste 203, Kingman, AZ 86409
Phone: 928-757-3133    
Virginia Durrett, NP
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Practice Location: 3397 Rosewood St, Kingman, AZ 86401
Phone: 928-897-8743    
Mrs. Lisa Marie Land, NP-C, ACNPC-AG
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Medicare: Accepting Medicare Assignments
Practice Location: 1739 E Beverly Ave, Suite 203, Kingman, AZ 86409
Phone: 928-757-3133    
Andrew Conrad Rucker,
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Medicare: Accepting Medicare Assignments
Practice Location: 3269 N Stockton Hill Rd, Kingman, AZ 86409
Phone: 928-757-2101    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.