Shannakay Juddian Thompson-white, in Philadelphia, PA

Shannakay Juddian Thompson-white, is a medicare enrolled "Nurse Practitioner - Family" in Philadelphia, Pennsylvania. Her current practice location is 1205 Shelmire Ave, Philadelphia, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (856) 392-9900.

Shannakay Juddian Thompson-white is licensed to practice in New Jersey (license number 26NJ01374700) 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 1073235578.

Contact Information

	Shannakay Juddian Thompson-white,
	1205 Shelmire Ave, Philadelphia, PA 19111-2726
	(856) 392-9900
	Not Available

Map and Direction

Provider's Profile

Full Name	Shannakay Juddian Thompson-white
Gender	Female
Speciality	Nurse Practitioner - Family
Location	1205 Shelmire Ave, Philadelphia, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1073235578
Provider Enumeration Date: 07/19/2022
Last Update Date: 11/15/2022

Medicare PECOS Information:

PECOS PAC ID: 0143686055
Enrollment ID: I20230519000016

Medical Identifiers

Medical identifiers for Shannakay Juddian Thompson-white such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1073235578	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	26NR19666000 (New Jersey)	Secondary
163W00000X	Registered Nurse	RN695502 (Pennsylvania)	Secondary
363LF0000X	Nurse Practitioner - Family	26NJ01374700 (New Jersey)	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. Shannakay Juddian Thompson-white allows following entities to bill medicare on her behalf.

Entity Name	Complete Care Of South Jersey
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1518320555 PECOS PAC ID: 8820389257 Enrollment ID: O20160615001232

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. Shannakay Juddian Thompson-white 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
Shannakay Juddian Thompson-white, 1205 Shelmire Ave, Philadelphia, PA 19111-2726 Ph: (856) 392-9900	Shannakay Juddian Thompson-white, 1205 Shelmire Ave, Philadelphia, PA 19111-2726 Ph: (856) 392-9900

Reviews and Comments

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Shannakay Juddian Thompson-white, - Medicare Nurse Practitioner in Philadelphia, PA