Jeremy Elliott, is a medicare enrolled "Nurse Practitioner - Family" in White Hall, Illinois. He graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Thomas H Boyd Memorial Hospital and his current practice location is
116a N Main St, White Hall, Illinois. You can reach out to his office (for appointments etc.) via phone at
(217) 374-2188.
Jeremy Elliott is licensed to practice in Illinois (license number 209022227) 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 1003416546.
Provider's Profile
| Full Name | Jeremy Elliott |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 4 Years |
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| Location | 116a N Main St, White Hall, Illinois |
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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:
- Jeremy Elliott graduated from nursing school in 2020
NPI Data:
- NPI Number: 1003416546
- Provider Enumeration Date: 10/26/2020
- Last Update Date: 01/10/2022
Medicare PECOS Information:
- PECOS PAC ID: 3678984556
- Enrollment ID: I20201125000758
Medical Identifiers
Medical identifiers for Jeremy Elliott such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1003416546 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 209022227 (Illinois) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Thomas H Boyd Memorial Hospital | 8123085560 | 24 |
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. Jeremy Elliott allows following entities to bill medicare on his behalf.
| Entity Name | Thomas H Boyd Memorial Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1811096811
PECOS PAC ID: 8123085560
Enrollment ID: O20041216000800 |
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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. Jeremy Elliott 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 |
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Jeremy Elliott,
115 White Hall St,
Patterson, IL 62078-1011
Ph: (217) 691-0364 | Jeremy Elliott,
116a N Main St,
White Hall, IL 62092-1054
Ph: (217) 374-2188 |
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