Pamela Nicole Dallas, in Ellenwood, GA - Medicare Nurse Practitioner

Pamela Nicole Dallas, is a medicare enrolled "Nurse Practitioner - Family" in Ellenwood, Georgia. Her current practice location is 3462 Ashford Loop, Ellenwood, Georgia. You can reach out to her office (for appointments etc.) via phone at (770) 364-2666.

Pamela Nicole Dallas is licensed to practice in Georgia (license number RN242295) 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 1770247066.

Contact Information

	Pamela Nicole Dallas,
	3462 Ashford Loop, Ellenwood, GA 30294-3674
	(770) 364-2666
	Not Available

Map and Direction

Provider's Profile

Full Name	Pamela Nicole Dallas
Gender	Female
Speciality	Nurse Practitioner - Family
Location	3462 Ashford Loop, Ellenwood, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1770247066
Provider Enumeration Date: 10/24/2021
Last Update Date: 08/07/2023

Medicare PECOS Information:

PECOS PAC ID: 7810359908
Enrollment ID: I20230822002438

Medical Identifiers

Medical identifiers for Pamela Nicole Dallas such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1770247066	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163WM0102X	Registered Nurse - Maternal Newborn	RN242295 (Georgia)	Secondary
363LF0000X	Nurse Practitioner - Family	RN242295 (Georgia)	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. Pamela Nicole Dallas allows following entities to bill medicare on her behalf.

Entity Name	Tlc Of Georgia Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1750677241 PECOS PAC ID: 5496924490 Enrollment ID: O20110809000175

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. Pamela Nicole Dallas 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
Pamela Nicole Dallas, 3462 Ashford Loop, Ellenwood, GA 30294-3674 Ph: () -	Pamela Nicole Dallas, 3462 Ashford Loop, Ellenwood, GA 30294-3674 Ph: (770) 364-2666

Reviews and Comments

Nurse Practitioner Nurses in Ellenwood, GA

Sharalyn Marrion Martin, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 209 Saint Lukes Way, Ellenwood, GA 30294 Phone: 678-520-1616
Jacqueline Lewis, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 304 Summit Heights Ct Ste 120, Ellenwood, GA 30294 Phone: 404-552-5128
Ms. Abosede Haygood, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4639 River Hill Cir, Ellenwood, GA 30294 Phone: 404-259-0967
Ngassa Nchapada Menga Faith, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2568 Brittany Park Cv, Ellenwood, GA 30294 Phone: 404-578-5437
Rose Senge Kombe, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 211 Fairview Rd, Ellenwood, GA 30294 Phone: 678-289-6747 Fax: 678-289-6750
Mrs. Terrilyn D Lemons, APRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4018 Park Place Cir, Ellenwood, GA 30294 Phone: 404-212-1024 Fax: 404-212-1024
Ms. Kakethia S. Mack, NURSE PRACTITIONER Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4124 Bosenberry Way, Ellenwood, GA 30294 Phone: 678-463-6568 Fax: 678-463-6568

Pamela Nicole Dallas, - Medicare Nurse Practitioner in Ellenwood, GA