Mrs Jaci 'k' Jean Phillips, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Broadus, Montana. Her current practice location is
507 North Lincoln Avenue, Broadus, Montana. You can reach out to her office (for appointments etc.) via phone at
(406) 436-2651.
Mrs Jaci 'k' Jean Phillips is licensed to practice in Montana (license number 24922) 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 1396052379.
Provider's Profile
| Full Name | Mrs Jaci 'k' Jean Phillips |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 507 North Lincoln Avenue, Broadus, Montana |
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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: 1396052379
- Provider Enumeration Date: 09/11/2010
- Last Update Date: 03/05/2015
Medicare PECOS Information:
- PECOS PAC ID: 1052595931
- Enrollment ID: I20110419000023
Medical Identifiers
Medical identifiers for Mrs Jaci 'k' Jean Phillips such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1396052379 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 24922 (Montana) | 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. Mrs Jaci 'k' Jean Phillips allows following entities to bill medicare on her behalf.
| Entity Name | Powder River County |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1851791750
PECOS PAC ID: 2860543667
Enrollment ID: O20141105000008 |
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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. Mrs Jaci 'k' Jean Phillips 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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Mrs Jaci 'k' Jean Phillips, FNP-BC
507 North Lincoln Avenue, P.o. Box 489,
Broadus, MT 59317-0489
Ph: (406) 436-2651 | Mrs Jaci 'k' Jean Phillips, FNP-BC
507 North Lincoln Avenue,
Broadus, MT 59317-0489
Ph: (406) 436-2651 |
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