Jessica K Shutt, RNCS is a medicare enrolled "Clinical Nurse Specialist - Psychiatric/mental Health, Adult" in Orange City, Florida. Her current practice location is
2725 Rebecca Ln Ste 107, Orange City, Florida. You can reach out to her office (for appointments etc.) via phone at
(386) 775-0736.
Jessica K Shutt is licensed to practice in Florida (license number 9410846) 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 1700052214.
Provider's Profile
| Full Name | Jessica K Shutt |
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| Gender | Female |
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| Speciality | Clinical Nurse Specialist - Psychiatric/mental Health, Adult |
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| Location | 2725 Rebecca Ln Ste 107, Orange City, Florida |
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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: 1700052214
- Provider Enumeration Date: 05/05/2008
- Last Update Date: 12/12/2023
Medicare PECOS Information:
- PECOS PAC ID: 7315016201
- Enrollment ID: I20231113001538
Medical Identifiers
Medical identifiers for Jessica K Shutt such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1700052214 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 364SP0809X | Clinical Nurse Specialist - Psychiatric/mental Health, Adult | 233581 (Massachusetts) | Secondary |
| 364SP0809X | Clinical Nurse Specialist - Psychiatric/mental Health, Adult | 9410846 (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. Jessica K Shutt allows following entities to bill medicare on her behalf.
| Entity Name | Adly Thebaud,md,pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1417018482
PECOS PAC ID: 0143270579
Enrollment ID: O20050124001039 |
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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. Jessica K Shutt 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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Jessica K Shutt, RNCS
2725 Rebecca Ln Ste 107,
Orange City, FL 32763-8350
Ph: (386) 775-0736 | Jessica K Shutt, RNCS
2725 Rebecca Ln Ste 107,
Orange City, FL 32763-8350
Ph: (386) 775-0736 |
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