Jennifer Blaylock, FNP is a medicare enrolled "Nurse Practitioner - Primary Care" in Polk City, Iowa. Her current practice location is
1010 S 3rd St, Polk City, Iowa. You can reach out to her office (for appointments etc.) via phone at
(515) 986-6426.
Jennifer Blaylock is licensed to practice in Iowa (license number A172505) 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 1316651524.
Provider's Profile
| Full Name | Jennifer Blaylock |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Primary Care |
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| Location | 1010 S 3rd St, Polk City, Iowa |
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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: 1316651524
- Provider Enumeration Date: 01/11/2023
- Last Update Date: 03/25/2024
Medicare PECOS Information:
- PECOS PAC ID: 9638528425
- Enrollment ID: I20231205002357
Medical Identifiers
Medical identifiers for Jennifer Blaylock such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1316651524 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | A172505 (Iowa) | Secondary |
| 363LP2300X | Nurse Practitioner - Primary Care | A172505 (Iowa) | 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. Jennifer Blaylock allows following entities to bill medicare on her behalf.
| Entity Name | On With Life Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1336633346
PECOS PAC ID: 4385553965
Enrollment ID: O20181019001088 |
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| Entity Name | Douglas A Layton Do |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1336781855
PECOS PAC ID: 8325495294
Enrollment ID: O20231114003673 |
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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. Jennifer Blaylock 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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Jennifer Blaylock, FNP
15196 Nw 16th St,
Slater, IA 50244-8019
Ph: (515) 619-1475 | Jennifer Blaylock, FNP
1010 S 3rd St,
Polk City, IA 50226-1130
Ph: (515) 986-6426 |
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