Carolyn R Fegenbush, ARNP is a medicare enrolled "Nurse Practitioner" physician in Jeffersonville, Indiana. She graduated from medical school in 1987 and has 37 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice North Clark Medical Group Llc, Zilmed Llc, Zilmed Llc and her current practice location is
1802 E 10th St, Jeffersonville, Indiana. You can reach out to her office (for appointments etc.) via phone at
(812) 288-2488.
Carolyn R Fegenbush is licensed to practice in Indiana (license number 71001579A) 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 1629009790.
Physician's Profile
| Full Name | Carolyn R Fegenbush |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 37 Years |
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| Location | 1802 E 10th St, Jeffersonville, Indiana |
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| Accepts Medicare Assignments | Yes. She 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:
- Carolyn R Fegenbush graduated from medical school in 1987
NPI Data:
- NPI Number: 1629009790
- Provider Enumeration Date: 07/06/2006
- Last Update Date: 11/08/2021
Medicare PECOS Information:
- PECOS PAC ID: 9638139587
- Enrollment ID: I20041014000657
Medical Identifiers
Medical identifiers for Carolyn R Fegenbush such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1629009790 | NPI | - | NPPES |
| 2823492000 | Other | | PASSPORT ADVANTAGE |
| 200451720 | Medicaid | IN | |
| 50014111 | Other | | PASSPORT |
| 78010824 | Medicaid | KY | |
| P00424435 | Other | | RAILROAD MEDICARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207QA0401X | Family Medicine - Addiction Medicine | 71001579A (Indiana) | Secondary |
| 363L00000X | Nurse Practitioner | 71001579A (Indiana) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| North Clark Medical Group Llc | 3971879354 | 23 |
| Zilmed Llc | 9133465941 | 3 |
| Zilmed Llc | 9133465941 | 3 |
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. Carolyn R Fegenbush allows following entities to bill medicare on her behalf.
| Entity Name | North Clark Medical Group Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376095711
PECOS PAC ID: 3971879354
Enrollment ID: O20171031000657 |
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| Entity Name | Zilmed Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1083131957
PECOS PAC ID: 9133465941
Enrollment ID: O20190116001390 |
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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. Carolyn R Fegenbush 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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Carolyn R Fegenbush, ARNP
2100 Market St Ste 101,
Charlestown, IN 47111-9535
Ph: (812) 503-5100 | Carolyn R Fegenbush, ARNP
1802 E 10th St,
Jeffersonville, IN 47130-6016
Ph: (812) 288-2488 |
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