Chanda D'riece Jackson, PT in Thomas, OK - Medicare Physical Therapist Provider

Chanda D'riece Jackson, PT is a medicare enrolled "Physical Therapist" provider in Thomas, Oklahoma. Her current practice location is 100 S 2nd Street, Thomas, Oklahoma. You can reach out to her office (for appointments etc.) via phone at (580) 661-2639.

Chanda D'riece Jackson is licensed to practice in Oklahoma (license number 3728) 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 1063440436.

Contact Information

	Chanda D'riece Jackson, PT
	100 S 2nd Street, Thomas, OK 73669
	(580) 661-2639
	(580) 661-2640

Map and Direction

Healthcare Provider's Profile

Full Name	Chanda D'riece Jackson
Gender	Female
Speciality	Physical Therapist
Location	100 S 2nd Street, Thomas, Oklahoma
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1063440436
Provider Enumeration Date: 06/28/2006
Last Update Date: 03/18/2014

Medicare PECOS Information:

PECOS PAC ID: 0446341606
Enrollment ID: I20070802000526

Medical Identifiers

Medical identifiers for Chanda D'riece Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063440436	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	3728 (Oklahoma)	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. Chanda D'riece Jackson allows following entities to bill medicare on her behalf.

Provider Name	Body Works Physical Therapy & Wellness, Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1265854913 PECOS PAC ID: 3779713854 Enrollment ID: O20140312000090

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. Chanda D'riece Jackson 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
Chanda D'riece Jackson, PT Po Box 797, Thomas, OK 73669-0797 Ph: (580) 661-2639	Chanda D'riece Jackson, PT 100 S 2nd Street, Thomas, OK 73669 Ph: (580) 661-2639

Reviews and Comments

Physical Therapist in Thomas, OK

Emma Katherine Niblett, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 104 N Main St, Thomas, OK 73669 Phone: 580-661-3517
Kids Therapy Connection Pllc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 104 N Main, Thomas, OK 73669 Phone: 405-397-5957 Fax: 580-623-5918
Shelby Thomas, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 104 N Main Street, Thomas, OK 73669 Phone: 580-661-3517

Chanda D'riece Jackson, PT - Medicare Physical Therapist in Thomas, OK