Jacqueline S Shriver, CRNP - Medicare Nurse Practitioner in Saint Marys, OH

Jacqueline S Shriver, CRNP is a medicare enrolled "Nurse Practitioner - Women's Health" in Saint Marys, Ohio. She graduated from nursing school in 1996 and has 28 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Jtdm Family Practice Llc and her current practice location is 1140 S Knoxville Ave Ste B, Saint Marys, Ohio. You can reach out to her office (for appointments etc.) via phone at (419) 394-7314.

Jacqueline S Shriver is licensed to practice in Ohio (license number NP2122) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1083606610.

Contact Information

Jacqueline S Shriver, CRNP
1140 S Knoxville Ave Ste B,
Saint Marys, OH 45885-2609
(419) 394-7314
(419) 394-7313

Map and Direction




Provider's Profile

Full NameJacqueline S Shriver
GenderFemale
SpecialityNurse Practitioner
Experience28 Years
Location1140 S Knoxville Ave Ste B, Saint Marys, Ohio
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jacqueline S Shriver graduated from nursing school in 1996
  NPI Data:
  • NPI Number: 1083606610
  • Provider Enumeration Date: 08/19/2005
  • Last Update Date: 04/19/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 5698765097
  • Enrollment ID: I20040517001099

Medical Identifiers

Medical identifiers for Jacqueline S Shriver such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1083606610NPI-NPPES
9934723OtherOHGROUP MEDICARE
1184652539OtherOHGROUP NPI
0742307MedicaidOH
H561340OtherOHMEDICARE PTAN
0105065OtherOHMEDICAID GROUP
34-1689161OtherOHGROUP TAX ID

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LW0102XNurse Practitioner - Women's Health NP2122 (Ohio)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Grand Lake Health SystemSaint marys, OHHospital
Mercer County Joint Township Community HospitalColdwater, OHHospital
Mercy Health-st Rita's Medical CenterLima, OHHospital
Lima Memorial Health SystemLima, OHHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Jtdm Family Practice Llc216341583739

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. Jacqueline S Shriver allows following entities to bill medicare on her behalf.
Entity NameJtdm Family Practice Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1184652539
PECOS PAC ID: 2163415837
Enrollment ID: O20040407000863

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. Jacqueline S Shriver 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 AddressPractice Location Address
Jacqueline S Shriver, CRNP
200 Saint Clair Ave,
Saint Marys, OH 45885-2400

Ph: (419) 300-1129
Jacqueline S Shriver, CRNP
1140 S Knoxville Ave Ste B,
Saint Marys, OH 45885-2609

Ph: (419) 394-7314

Reviews and Comments


Nurse Practitioner Nurses in Saint Marys, OH

Alex Michael Rowen,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 200 Saint Clair Ave, Saint Marys, OH 45885
Phone: 419-394-3335    
Kimberly Lynn Sadler, APRN CNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1050 East Greenville Rd, Saint Marys, OH 45885
Phone: 419-394-3331    Fax: 419-394-3330
Brittany Faye Schlarman, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1140 S Knoxville Ave Ste C, Saint Marys, OH 45885
Phone: 419-394-9595    Fax: 419-394-9532
Amanda Leigh Perry, AG-ACNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1140 S Knoxville Ave Ste C, Saint Marys, OH 45885
Phone: 419-394-9595    Fax: 419-394-9532
Jayaben D Patel, NP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1140 S Knoxville Ave Ste A, Saint Marys, OH 45885
Phone: 419-394-9959    Fax: 419-394-0255
Mrs. Kimberly Wiener, NP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 200 Saint Clair Ave, Saint Marys, OH 45885
Phone: 419-890-7970    Fax: 419-394-9556

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.