Dr Brian Edward Shockley, D P M is a medicare enrolled "Podiatrist" provider in Vicksburg, Mississippi. He went to University Of Iowa, Rj & L Carver College Of Medicine and graduated in 1996 and has 28 years of diverse experience with area of expertise as Podiatry. His current practice location is
1814 Mission 66, Vicksburg, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(601) 638-7520.
Dr Brian Edward Shockley is licensed to practice in Mississippi (license number MS80142) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1477662229.
Healthcare Provider's Profile
| Full Name | Dr Brian Edward Shockley |
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| Gender | Male |
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| Speciality | Podiatry |
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| Experience | 28 Years |
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| Location | 1814 Mission 66, Vicksburg, Mississippi |
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| Accepts Medicare Assignments | Yes. He 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:
- Dr Brian Edward Shockley attended and graduated from University Of Iowa, Rj & L Carver College Of Medicine in 1996
NPI Data:
- NPI Number: 1477662229
- Provider Enumeration Date: 08/29/2006
- Last Update Date: 01/26/2011
Medicare PECOS Information:
- PECOS PAC ID: 8325093792
- Enrollment ID: I20110329000330
Medical Identifiers
Medical identifiers for Dr Brian Edward Shockley such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1477662229 | NPI | - | NPPES |
| 5963224 | Other | LA | AETNA |
| 00119033 | Medicaid | MS | |
| 1540447 | Medicaid | LA | |
| 4800026580 | Other | LA | RAILROAD MEDICARE |
| 1851563 | Other | MS | UNITED HEALTHCARE |
| 4342670001 | Other | MS | MEDICARE DME |
| 5963224 | Other | MS | AETNA |
| 480026580 | Other | MS | RAILROAD MEDICARE |
| 1851563 | Other | LA | UNITED HEALTHCARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 213E00000X | Podiatrist | MS80142 (Mississippi) | Primary |
Medical Facilities Affiliation
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. Dr Brian Edward Shockley allows following entities to bill medicare on his behalf.
| Provider Name | Delta Foot Clinics, Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1962689042
PECOS PAC ID: 9133176209
Enrollment ID: O20110329000269 |
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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. Dr Brian Edward Shockley 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 |
|---|
Dr Brian Edward Shockley, D P M
1814 Mission 66,
Vicksburg, MS 39180-3710
Ph: (601) 638-7520 | Dr Brian Edward Shockley, D P M
1814 Mission 66,
Vicksburg, MS 39180-3710
Ph: (601) 638-7520 |
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