Jackie Clark, in Parrish, FL - Medicare Occupational Therapist Provider

Jackie Clark, is a medicare enrolled "Occupational Therapist" provider in Parrish, Florida. His current practice location is 11472 Walden Loop, Parrish, Florida. You can reach out to his office (for appointments etc.) via phone at (941) 806-7555.

Jackie Clark is licensed to practice in Florida (license number OT14395) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1124474457.

Contact Information

	Jackie Clark,
	11472 Walden Loop, Parrish, FL 34219-7565
	(941) 806-7555
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jackie Clark
Gender	Male
Speciality	Occupational Therapist
Location	11472 Walden Loop, Parrish, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1124474457
Provider Enumeration Date: 05/05/2016
Last Update Date: 12/06/2016

Medicare PECOS Information:

PECOS PAC ID: 3375978018
Enrollment ID: I20231213001000

Medical Identifiers

Medical identifiers for Jackie Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1124474457	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225X00000X	Occupational Therapist	OT14395 (Florida)	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. Jackie Clark allows following entities to bill medicare on his behalf.

Provider Name	Smile Home Therapy Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1861273054 PECOS PAC ID: 2769831916 Enrollment ID: O20231213000931

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. Jackie Clark 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
Jackie Clark, 11472 Walden Loop, Parrish, FL 34219-7565 Ph: (941) 806-7555	Jackie Clark, 11472 Walden Loop, Parrish, FL 34219-7565 Ph: (941) 806-7555

Reviews and Comments

Occupational Therapist in Parrish, FL

Brittney Leibham, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 11667 Little River Way, Parrish, FL 34219 Phone: 630-209-9003 Fax: 630-209-9003
Mallory Ann Rickloff, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 16502 Golf Course Rd, Parrish, FL 34219 Phone: 814-490-9580
Chelsy Ann Hendrix, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 3805 Twin Rivers Trl, Parrish, FL 34219 Phone: 859-608-7139
Elizabeth Wetzel, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 3029 River Woods Dr, Parrish, FL 34219 Phone: 941-776-3192
Lawrence Allen Henry, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 11308 28th Street Cir E, Parrish, FL 34219 Phone: 941-776-3980
Mrs. Jyoti Gupta, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 11131 58th Street Cir E, Parrish, FL 34219 Phone: 727-744-9588

Jackie Clark, - Medicare Occupational Therapist in Parrish, FL