Mrs Jennifer Pettit, APRN is a medicare enrolled "Nurse Practitioner - Acute Care" in Roland, Oklahoma. Her current practice location is
100 Woodland Hills Blvd, Roland, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(918) 503-6464.
Mrs Jennifer Pettit is licensed to practice in Oklahoma (license number 203920) 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 1114599081.
Provider's Profile
| Full Name | Mrs Jennifer Pettit |
|---|
| Gender | Female |
|---|
| Speciality | Nurse Practitioner - Acute Care |
|---|
| Location | 100 Woodland Hills Blvd, Roland, Oklahoma |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1114599081
- Provider Enumeration Date: 07/12/2021
- Last Update Date: 01/17/2023
Medicare PECOS Information:
- PECOS PAC ID: 9537524368
- Enrollment ID: I20230502000098
Medical Identifiers
Medical identifiers for Mrs Jennifer Pettit such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1114599081 | NPI | - | NPPES |
| 288261758 | Medicaid | AR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LA2100X | Nurse Practitioner - Acute Care | 203920 (Oklahoma) | Secondary |
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 Jennifer Pettit allows following entities to bill medicare on her behalf.
| Entity Name | Cherokee Nation |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1780692723
PECOS PAC ID: 5799698742
Enrollment ID: O20031106000628 |
|---|
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 Jennifer Pettit 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 Jennifer Pettit, APRN
10929 Old Highway 71,
Fort Smith, AR 72916-8160
Ph: (479) 250-1562 | Mrs Jennifer Pettit, APRN
100 Woodland Hills Blvd,
Roland, OK 74954-5213
Ph: (918) 503-6464 |
Reviews and Comments