Dr Bethany Wall Jackson, MD in Rome, GA

Dr Bethany Wall Jackson, MD is a medicare enrolled "Pediatrics" physician in Rome, Georgia. Her current practice location is 304 Shorter Ave Nw Ste 105, Rome, Georgia. You can reach out to her office (for appointments etc.) via phone at (706) 291-4880.

Dr Bethany Wall Jackson is licensed to practice in Georgia (license number 060642) 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 1033396841.

Contact Information

	Dr Bethany Wall Jackson, MD
	304 Shorter Ave Nw Ste 105, Rome, GA 30165-4256
	(706) 291-4880
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Bethany Wall Jackson
Gender	Female
Speciality	Pediatrics
Location	304 Shorter Ave Nw Ste 105, Rome, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1033396841
Provider Enumeration Date: 01/23/2008
Last Update Date: 03/10/2023

Medicare PECOS Information:

PECOS PAC ID: 8527205723
Enrollment ID: I20130507000532

Medical Identifiers

Medical identifiers for Dr Bethany Wall Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1033396841	NPI	-	NPPES
003132526A	Medicaid	GA
003132526B	Medicaid	GA
146978	Medicaid	AL

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	060642 (Georgia)	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. Dr Bethany Wall Jackson allows following entities to bill medicare on her behalf.

Entity Name	Adventist Health System Georgia Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1699791343 PECOS PAC ID: 4486568037 Enrollment ID: O20031203000557

Entity Name	Floyd Healthcare Management Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1689610149 PECOS PAC ID: 5193633386 Enrollment ID: O20040127000897

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 Bethany Wall 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
Dr Bethany Wall Jackson, MD 420 E 2nd Ave Ste 103, Rome, GA 30161-3210 Ph: (706) 509-3000	Dr Bethany Wall Jackson, MD 304 Shorter Ave Nw Ste 105, Rome, GA 30165-4256 Ph: (706) 291-4880

Reviews and Comments

Pediatrics Doctors in Rome, GA

Todd Rufus Kelley, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 85 John Maddox Drive Connector Nw, Rome, GA 30165 Phone: 762-235-2990 Fax: 706-238-8031
Laura M. Dovan, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 330 Turner Mccall Blvd., Suite 205, Rome, GA 30165 Phone: 706-234-2324 Fax: 706-234-1491
Erica Paez-zapata, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 18 Riverbend Dr Sw Ste 210, Rome, GA 30161 Phone: 706-528-4949 Fax: 706-204-8274
David Michael Dohrmann, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 330 Turner Mccall Blvd Sw, Rome, GA 30165 Phone: 706-238-8030 Fax: 706-238-8031
Henaro C Sabino Jr., M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 504 Redmond Rd Nw, Rome, GA 30165 Phone: 706-235-3855 Fax: 706-290-2710
Katarina Williams, CPNP-PC, BSN, RN Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 140 Three Rivers Dr Ne, Rome, GA 30161 Phone: 706-232-1300

Dr Bethany Wall Jackson, MD - Medicare Pediatrics in Rome, GA