Dr Jacqueline Marie Johnson, DO is a medicare enrolled "Family Medicine" physician in Myrtle Creek, Oregon. She went to At Still University Of Health Sciences, College Of Osteo Med, Kirksville and graduated in 2006 and has 20 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Evergreen Family Medicine Pc, Centennial Medical Group East Llc and her current practice location is
145 Ne Broadway St, Myrtle Creek, Oregon. You can reach out to her office (for appointments etc.) via phone at
(541) 677-7200.
Dr Jacqueline Marie Johnson is licensed to practice in Oregon (license number DO161555) 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 1083814099.
Physician's Profile
| Full Name | Dr Jacqueline Marie Johnson |
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| Gender | Female |
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| Speciality | Family Practice |
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| Experience | 20 Years |
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| Location | 145 Ne Broadway St, Myrtle Creek, Oregon |
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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. |
Medical Education and Training:
- Dr Jacqueline Marie Johnson attended and graduated from At Still University Of Health Sciences, College Of Osteo Med, Kirksville in 2006
NPI Data:
- NPI Number: 1083814099
- Provider Enumeration Date: 07/19/2007
- Last Update Date: 08/09/2023
Medicare PECOS Information:
- PECOS PAC ID: 0244470805
- Enrollment ID: I20130703000184
Medical Identifiers
Medical identifiers for Dr Jacqueline Marie Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1083814099 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207Q00000X | Family Medicine | O-0482 (Idaho) | Secondary |
| 207Q00000X | Family Medicine | DO161555 (Oregon) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| Evergreen Family Medicine Pc | 3870485139 | 53 |
| Centennial Medical Group East Llc | 9234397878 | 61 |
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. Dr Jacqueline Marie Johnson allows following entities to bill medicare on her behalf.
| Entity Name | Centennial Medical Group East Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1134436637 PECOS PAC ID: 9234397878 Enrollment ID: O20120228000510 |
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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. Dr Jacqueline Marie Johnson 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 |
Dr Jacqueline Marie Johnson, DO 2570 Nw Edenbower Blvd Ste 100, Roseburg, OR 97471-6214 Ph: (541) 677-7200 | Dr Jacqueline Marie Johnson, DO 145 Ne Broadway St, Myrtle Creek, OR 97457-9039 Ph: (541) 677-7200 |
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