Ms Jacquelyn Marie Wooldridge, CNS is a medicare enrolled "Clinical Nurse Specialist - Psychiatric/mental Health, Adult" in Joplin, Missouri. Her current practice location is
3901 E 32nd St, Joplin, Missouri. You can reach out to her office (for appointments etc.) via phone at
(417) 347-7540.
Ms Jacquelyn Marie Wooldridge is licensed to practice in Missouri (license number 2000174217) 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 1972697696.
Provider's Profile
| Full Name | Ms Jacquelyn Marie Wooldridge |
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| Gender | Female |
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| Speciality | Clinical Nurse Specialist - Psychiatric/mental Health, Adult |
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| Location | 3901 E 32nd St, Joplin, Missouri |
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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: 1972697696
- Provider Enumeration Date: 10/03/2006
- Last Update Date: 04/24/2019
Medicare PECOS Information:
- PECOS PAC ID: 7113041856
- Enrollment ID: I20100901000423
Medical Identifiers
Medical identifiers for Ms Jacquelyn Marie Wooldridge such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1972697696 | NPI | - | NPPES |
| 425193406 | Medicaid | MO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 364SP0809X | Clinical Nurse Specialist - Psychiatric/mental Health, Adult | 2000174217 (Missouri) | 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. Ms Jacquelyn Marie Wooldridge allows following entities to bill medicare on her behalf.
| Entity Name | Ozark Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1790796878
PECOS PAC ID: 4789588088
Enrollment ID: O20050223000110 |
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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. Ms Jacquelyn Marie Wooldridge 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 |
|---|
Ms Jacquelyn Marie Wooldridge, CNS
Po Box 2526,
Joplin, MO 64803-2526
Ph: (417) 347-7540 | Ms Jacquelyn Marie Wooldridge, CNS
3901 E 32nd St,
Joplin, MO 64804-3312
Ph: (417) 347-7540 |
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