Etta Renee Rich, is a medicare enrolled "Occupational Therapist" provider in Rogersville, Tennessee. She graduated from medical school in 2019 and has 5 years of diverse experience with area of expertise as Occupational Therapy. She is a member of the group practice Jordan C Black and her current practice location is
900 W Main St, Rogersville, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(423) 500-5600.
Etta Renee Rich is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1902437478.
Healthcare Provider's Profile
| Full Name | Etta Renee Rich |
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| Gender | Female |
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| Speciality | Occupational Therapy |
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| Experience | 5 Years |
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| Location | 900 W Main St, Rogersville, Tennessee |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Etta Renee Rich graduated from medical school in 2019
NPI Data:
- NPI Number: 1902437478
- Provider Enumeration Date: 02/03/2020
- Last Update Date: 10/15/2024
Medicare PECOS Information:
- PECOS PAC ID: 5890112593
- Enrollment ID: I20220407002110
Medical Identifiers
Medical identifiers for Etta Renee Rich such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1902437478 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225X00000X | Occupational Therapist | (* (Not Available)) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Jordan C Black | 5890117469 | 21 |
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. Etta Renee Rich allows following entities to bill medicare on her behalf.
| Provider Name | Jordan C Black |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1528569316
PECOS PAC ID: 5890117469
Enrollment ID: O20200629000595 |
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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. Etta Renee Rich 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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Etta Renee Rich,
325 W Morris Blvd,
Morristown, TN 37813-2237
Ph: (423) 375-8907 | Etta Renee Rich,
900 W Main St,
Rogersville, TN 37857-2448
Ph: (423) 500-5600 |
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