Samuel Richardson Jackson, in Chester, VA - Medicare Physical Therapist Provider

Samuel Richardson Jackson, is a medicare enrolled "Physical Therapist" provider in Chester, Virginia. His current practice location is 10438 Iron Bridge Rd, Chester, Virginia. You can reach out to his office (for appointments etc.) via phone at (804) 796-1518.

Samuel Richardson Jackson is licensed to practice in North Carolina (license number P20566) 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 1588204721.

Contact Information

	Samuel Richardson Jackson,
	10438 Iron Bridge Rd, Chester, VA 23831-1427
	(804) 796-1518
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Samuel Richardson Jackson
Gender	Male
Speciality	Physical Therapist
Location	10438 Iron Bridge Rd, Chester, Virginia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1588204721
Provider Enumeration Date: 01/15/2020
Last Update Date: 09/21/2021

Medicare PECOS Information:

PECOS PAC ID: 6709216872
Enrollment ID: I20200414002328

Medical Identifiers

Medical identifiers for Samuel Richardson Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1588204721	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	2305213383 (Virginia)	Secondary
225100000X	Physical Therapist	P20566 (North Carolina)	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. Samuel Richardson Jackson allows following entities to bill medicare on his behalf.

Provider Name	Tidewater Physical Therapy Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1457389595 PECOS PAC ID: 6406759281 Enrollment ID: O20041019001029

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. Samuel Richardson 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
Samuel Richardson Jackson, 9101 Stony Point Pkwy Apt 1140, Richmond, VA 23235-2059 Ph: () -	Samuel Richardson Jackson, 10438 Iron Bridge Rd, Chester, VA 23831-1427 Ph: (804) 796-1518

Reviews and Comments

Physical Therapist in Chester, VA

Mrs. Dawn Tammy Snow, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 13048 Rivers Bend Rd, Chester, VA 23836 Phone: 804-530-3330 Fax: 804-530-9998
James P. Stroebel, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 10400 Iron Bridge Rd, Chester, VA 23831 Phone: 804-796-1518 Fax: 804-796-1543
Dr. Makenzi Spink Smithson, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3501 Festival Park Plz, Chester, VA 23831 Phone: 804-930-8280 Fax: 804-930-8101
Diana W Brooks, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 10400 Iron Bridge Rd, Chester, VA 23831 Phone: 804-796-1518 Fax: 804-796-1543
Nicole B Sandridge, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 13048 Rivers Bend Rd, Chester, VA 23836 Phone: 804-523-0333 Fax: 804-530-9998
Amy Willingham Dodd, MSPT, ATC Physical Therapist Medicare: Medicare Enrolled Practice Location: 13904 Twin Cliffs Ln, Chester, VA 23831 Phone: 804-399-8680
Kellie Taylor Hoffman, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3509 Festival Park Plz, Chester, VA 23831 Phone: 804-946-1250

Samuel Richardson Jackson, - Medicare Physical Therapist in Chester, VA