Jennifer Nichole Speelman, FNP-C is a medicare enrolled "Nurse Practitioner - Family" physician in Lagrange, Georgia. Her current practice location is
300 Medical Dr Ste 705, Lagrange, Georgia. You can reach out to her office (for appointments etc.) via phone at
(706) 803-7960.
Jennifer Nichole Speelman is licensed to practice in Georgia (license number RN217745) 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 1013487065.
Physician's Profile
Full Name | Jennifer Nichole Speelman |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 300 Medical Dr Ste 705, Lagrange, Georgia |
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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: 1013487065
- Provider Enumeration Date: 12/03/2018
- Last Update Date: 08/26/2025
Medicare PECOS Information:
- PECOS PAC ID: 4880930916
- Enrollment ID: I20190110002912
Medical Identifiers
Medical identifiers for Jennifer Nichole Speelman such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1013487065 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Y00000X | Otolaryngology | RN217745 (Georgia) | Secondary |
363L00000X | Nurse Practitioner | RN217745 (Georgia) | Secondary |
363LF0000X | Nurse Practitioner - Family | RN217745 (Georgia) | 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. Jennifer Nichole Speelman allows following entities to bill medicare on her behalf.
Entity Name | Lagrange Emergency Physicians, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1760437560 PECOS PAC ID: 0840207072 Enrollment ID: O20060314000271 |
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Entity Name | Wellstar Medical Group Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374 |
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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. Jennifer Nichole Speelman 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 |
Jennifer Nichole Speelman, FNP-C 300 Medical Dr Ste 705, Lagrange, GA 30240-4130 Ph: (706) 803-7960 | Jennifer Nichole Speelman, FNP-C 300 Medical Dr Ste 705, Lagrange, GA 30240-4130 Ph: (706) 803-7960 |
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