Jacqueline S Shriver, CRNP in Saint Marys, OH

Jacqueline S Shriver, CRNP is a medicare enrolled "Nurse Practitioner - Women's Health" in Saint Marys, Ohio. She graduated from nursing school in 1996 and has 28 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Jtdm Family Practice Llc and her current practice location is 1140 S Knoxville Ave Ste B, Saint Marys, Ohio. You can reach out to her office (for appointments etc.) via phone at (419) 394-7314.

Jacqueline S Shriver is licensed to practice in Ohio (license number NP2122) 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 1083606610.

Contact Information

	Jacqueline S Shriver, CRNP
	1140 S Knoxville Ave Ste B, Saint Marys, OH 45885-2609
	(419) 394-7314
	(419) 394-7313

Map and Direction

Provider's Profile

Full Name	Jacqueline S Shriver
Gender	Female
Speciality	Nurse Practitioner
Experience	28 Years
Location	1140 S Knoxville Ave Ste B, Saint Marys, Ohio
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Jacqueline S Shriver graduated from nursing school in 1996

NPI Data:

NPI Number: 1083606610
Provider Enumeration Date: 08/19/2005
Last Update Date: 04/19/2021

Medicare PECOS Information:

PECOS PAC ID: 5698765097
Enrollment ID: I20040517001099

Medical Identifiers

Medical identifiers for Jacqueline S Shriver such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1083606610	NPI	-	NPPES
9934723	Other	OH	GROUP MEDICARE
1184652539	Other	OH	GROUP NPI
0742307	Medicaid	OH
H561340	Other	OH	MEDICARE PTAN
0105065	Other	OH	MEDICAID GROUP
34-1689161	Other	OH	GROUP TAX ID

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LW0102X	Nurse Practitioner - Women's Health	NP2122 (Ohio)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Grand Lake Health System	Saint marys, OH	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Jtdm Family Practice Llc	2163415837	42

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. Jacqueline S Shriver allows following entities to bill medicare on her behalf.

Entity Name	Jtdm Family Practice Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1184652539 PECOS PAC ID: 2163415837 Enrollment ID: O20040407000863

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. Jacqueline S Shriver 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
Jacqueline S Shriver, CRNP 200 Saint Clair Ave, Saint Marys, OH 45885-2400 Ph: (419) 300-1129	Jacqueline S Shriver, CRNP 1140 S Knoxville Ave Ste B, Saint Marys, OH 45885-2609 Ph: (419) 394-7314

Reviews and Comments

Nurse Practitioner Nurses in Saint Marys, OH

Alex Michael Rowen, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 200 Saint Clair Ave, Saint Marys, OH 45885 Phone: 419-394-3335
Kimberly Lynn Sadler, APRN CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1050 East Greenville Rd, Saint Marys, OH 45885 Phone: 419-394-3331 Fax: 419-394-3330
Brittany Faye Schlarman, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1140 S Knoxville Ave Ste C, Saint Marys, OH 45885 Phone: 419-394-9595 Fax: 419-394-9532
Amanda Leigh Perry, AG-ACNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1140 S Knoxville Ave Ste C, Saint Marys, OH 45885 Phone: 419-394-9595 Fax: 419-394-9532
Jayaben D Patel, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1140 S Knoxville Ave Ste A, Saint Marys, OH 45885 Phone: 419-394-9959 Fax: 419-394-0255
Mrs. Kimberly Wiener, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 200 Saint Clair Ave, Saint Marys, OH 45885 Phone: 419-890-7970 Fax: 419-394-9556

Jacqueline S Shriver, CRNP - Medicare Nurse Practitioner in Saint Marys, OH