Bethany Herold, is a medicare enrolled "Occupational Therapist" provider in Madison, Georgia. Her current practice location is
1740 Lions Club Rd, Madison, Georgia. You can reach out to her office (for appointments etc.) via phone at
(706) 342-1667.
Bethany Herold is licensed to practice in Georgia (license number OT006262) 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 1316796584.
Healthcare Provider's Profile
| Full Name | Bethany Herold |
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| Gender | Female |
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| Speciality | Occupational Therapist |
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| Location | 1740 Lions Club Rd, Madison, Georgia |
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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: 1316796584
- Provider Enumeration Date: 05/17/2024
- Last Update Date: 05/17/2024
Medicare PECOS Information:
- PECOS PAC ID: 8628512449
- Enrollment ID: I20240703000381
Medical Identifiers
Medical identifiers for Bethany Herold such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1316796584 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225X00000X | Occupational Therapist | OT006262 (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. Bethany Herold allows following entities to bill medicare on her behalf.
| Provider Name | Legacy Healthcare Services Inc |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1528419751
PECOS PAC ID: 2163339722
Enrollment ID: O20160830000411 |
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| Provider Name | Legacy Healthcare Services Inc |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1831619337
PECOS PAC ID: 2163339722
Enrollment ID: O20220916001457 |
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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. Bethany Herold 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 |
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Bethany Herold,
1590 Calls Creek Cir,
Watkinsville, GA 30677-2575
Ph: (404) 395-2864 | Bethany Herold,
1740 Lions Club Rd,
Madison, GA 30650-4762
Ph: (706) 342-1667 |
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