Mrs Jacqueline Ann Carrillo, CFNP in Jackson, MS

Mrs Jacqueline Ann Carrillo, CFNP is a medicare enrolled "Nurse Practitioner - Family" in Jackson, Mississippi. Her current practice location is 2500 N State St, Jackson, Mississippi. You can reach out to her office (for appointments etc.) via phone at (601) 984-5610.

Mrs Jacqueline Ann Carrillo is licensed to practice in Mississippi (license number R752134) 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 1346460078.

Contact Information

	Mrs Jacqueline Ann Carrillo, CFNP
	2500 N State St, Jackson, MS 39216-4500
	(601) 984-5610
	(601) 984-5783

Map and Direction

Provider's Profile

Full Name	Mrs Jacqueline Ann Carrillo
Gender	Female
Speciality	Nurse Practitioner - Family
Location	2500 N State St, Jackson, Mississippi
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1346460078
Provider Enumeration Date: 04/26/2007
Last Update Date: 03/07/2023

Medicare PECOS Information:

PECOS PAC ID: 8123163318
Enrollment ID: I20100226000126

Medical Identifiers

Medical identifiers for Mrs Jacqueline Ann Carrillo such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1346460078	NPI	-	NPPES
09120238	Medicaid	MS
302I507415	Other	MS	MEDICARE PTAN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	R752134 (Mississippi)	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 Jacqueline Ann Carrillo allows following entities to bill medicare on her behalf.

Entity Name	St. Dominic Hospital Medicine Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1104362292 PECOS PAC ID: 5597034348 Enrollment ID: O20170711000091

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 Jacqueline Ann Carrillo 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
Mrs Jacqueline Ann Carrillo, CFNP Po Box 22727, Jackson, MS 39225-2727 Ph: (601) 200-4749	Mrs Jacqueline Ann Carrillo, CFNP 2500 N State St, Jackson, MS 39216-4500 Ph: (601) 984-5610

Reviews and Comments

Nurse Practitioner Nurses in Jackson, MS

Jennifer Nichols Foreman, A-GNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-984-5657
Susan B Patterson, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 501 Marshall St, Ste 104, Jackson, MS 39202 Phone: 601-969-6404 Fax: 601-973-4541
Caryl P. Sumrall, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6311 Ridgewood Rd, Jackson, MS 39211 Phone: 601-952-8398 Fax: 833-972-5586
Kathryn L. Navarro, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1850 Chadwick Dr, Jackson, MS 39204 Phone: 904-805-1300 Fax: 904-805-1302
Mr. Bradford Steele Martin, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2500 North State Street, Department Of Orthopedics, Jackson, MS 39216 Phone: 601-815-3045
Emily Brumfield, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2500 North State Street, Jackson, MS 39216 Phone: 601-984-5500 Fax: 601-984-5503
Mrs. Tiffany Griffin, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3450 Highway 80 West, Jackson, MS 39209 Phone: 601-321-2400

Mrs Jacqueline Ann Carrillo, CFNP - Medicare Nurse Practitioner in Jackson, MS