Dominique Nicole Light, MOTR/L in Jackson, TN - Medicare Occupational Therapist Provider

Dominique Nicole Light, MOTR/L is a medicare enrolled "Occupational Therapist - Pediatrics" provider in Jackson, Tennessee. Her current practice location is 176 W University Pkwy Ste E, Jackson, Tennessee. You can reach out to her office (for appointments etc.) via phone at (313) 004-9507.

Dominique Nicole Light is licensed to practice in Maryland (license number 0119007097) 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 1265980304.

Contact Information

	Dominique Nicole Light, MOTR/L
	176 W University Pkwy Ste E, Jackson, TN 38305-1618
	(313) 004-9507
	(731) 300-4951

Map and Direction

Healthcare Provider's Profile

Full Name	Dominique Nicole Light
Gender	Female
Speciality	Occupational Therapist - Pediatrics
Location	176 W University Pkwy Ste E, Jackson, Tennessee
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1265980304
Provider Enumeration Date: 09/19/2016
Last Update Date: 10/22/2023

Medicare PECOS Information:

PECOS PAC ID: 4284097460
Enrollment ID: I20230906001481

Medical Identifiers

Medical identifiers for Dominique Nicole Light such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1265980304	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225X00000X	Occupational Therapist	(* (Not Available))	Secondary
225XP0200X	Occupational Therapist - Pediatrics	0119007097 (Maryland)	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. Dominique Nicole Light allows following entities to bill medicare on her behalf.

Provider Name	Patterson Physical Therapy Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1770928533 PECOS PAC ID: 8022259878 Enrollment ID: O20130722000132

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. Dominique Nicole Light 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
Dominique Nicole Light, MOTR/L 7001a Loisdale Rd, Springfield, VA 22150-1904 Ph: (703) 971-0602	Dominique Nicole Light, MOTR/L 176 W University Pkwy Ste E, Jackson, TN 38305-1618 Ph: (313) 004-9507

Reviews and Comments

Occupational Therapist in Jackson, TN

Mrs. Brynn Shellene Smith, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 45 Forest Cv, Jackson, TN 38301 Phone: 731-424-4200
Ms. Johnetta Newson, OT Occupational Therapist Medicare: Medicare Enrolled Practice Location: 620 Skyline Dr, Jackson, TN 38301 Phone: 731-541-5000
Allison Ganier Havercamp, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 34 Garland Dr, Jackson, TN 38305 Phone: 731-668-3322
Mrs. Mary Elizabeth Craigie, OTRL Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 23 Glenwood Dr, Jackson, TN 38305 Phone: 731-664-9095
Penny Ann Gibson, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 34 Garland Dr, Jackson, TN 38305 Phone: 731-668-9070
Hayley Alexandria Lumpkin, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 34 Garland Dr, Jackson, TN 38305 Phone: 731-668-9070 Fax: 731-660-8739
Amanda Diez Stewart, OT Occupational Therapist Medicare: Medicare Enrolled Practice Location: 32 Garland Dr, Jackson, TN 38305 Phone: 731-664-3645 Fax: 731-668-6549

Dominique Nicole Light, MOTR/L - Medicare Occupational Therapist in Jackson, TN