Mrs Jennifer Lind Womack, RD, CDE is a medicare enrolled "Dietitian, Registered" provider in Fort Mohave, Arizona. Her current practice location is
5300 S. Highway 95 Ste A, Fort Mohave, Arizona. You can reach out to her office (for appointments etc.) via phone at
(928) 768-9496.
Mrs Jennifer Lind Womack is licensed to practice in Arizona (license number 817192) 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 1205931839.
Healthcare Provider's Profile
| Full Name | Mrs Jennifer Lind Womack |
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| Gender | Female |
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| Speciality | Dietitian, Registered |
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| Location | 5300 S. Highway 95 Ste A, Fort Mohave, Arizona |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1205931839
- Provider Enumeration Date: 09/14/2006
- Last Update Date: 07/21/2022
Medicare PECOS Information:
- PECOS PAC ID: 7012945835
- Enrollment ID: I20050802000446
Medical Identifiers
Medical identifiers for Mrs Jennifer Lind Womack such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1205931839 | NPI | - | NPPES |
| AZ0258900 | Other | AZ | BLUE CROSS BLUE SHIELD |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 133V00000X | Dietitian, Registered | 817192 (Arizona) | 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. Mrs Jennifer Lind Womack allows following entities to bill medicare on her behalf.
| Provider Name | Mohave Family Healthcare |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1043369168
PECOS PAC ID: 2860575941
Enrollment ID: O20080213000100 |
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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. Mrs Jennifer Lind Womack 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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Mrs Jennifer Lind Womack, RD, CDE
P.0. Box 9479,
Fort Mohave, AZ 86426
Ph: (928) 768-9496 | Mrs Jennifer Lind Womack, RD, CDE
5300 S. Highway 95 Ste A,
Fort Mohave, AZ 86426
Ph: (928) 768-9496 |
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