Mrs Katherine Wiley Poindexter, PA-C, RDN is a medicare enrolled "Dermatology" provider in Jacksonville, Florida. Her current practice location is
2804 Saint Johns Bluff Rd S Ste 109, Jacksonville, Florida. You can reach out to her office (for appointments etc.) via phone at
(904) 727-9123.
Mrs Katherine Wiley Poindexter is licensed to practice in Florida (license number PA9110905) 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 1538673058.
Healthcare Provider's Profile
| Full Name | Mrs Katherine Wiley Poindexter |
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| Gender | Female |
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| Speciality | Dermatology |
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| Location | 2804 Saint Johns Bluff Rd S Ste 109, Jacksonville, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1538673058
- Provider Enumeration Date: 11/20/2017
- Last Update Date: 07/21/2020
Medicare PECOS Information:
- PECOS PAC ID: 8820358468
- Enrollment ID: I20180130003157
Medical Identifiers
Medical identifiers for Mrs Katherine Wiley Poindexter such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1538673058 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 133V00000X | Dietitian, Registered | LD004401 (Georgia) | Secondary |
| 133V00000X | Dietitian, Registered | ND7238 (Florida) | Secondary |
| 207N00000X | Dermatology | PA9110905 (Florida) | Primary |
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 Katherine Wiley Poindexter 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 |
Mrs Katherine Wiley Poindexter, PA-C, RDN 2346 Jose Cir S, Jacksonville, FL 32217-3547 Ph: (404) 290-1456 | Mrs Katherine Wiley Poindexter, PA-C, RDN 2804 Saint Johns Bluff Rd S Ste 109, Jacksonville, FL 32246-3777 Ph: (904) 727-9123 |
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