Dr Shelly Holder Thompson, MD - Medicare Pediatrics in Jacksonville, FL

Dr Shelly Holder Thompson, MD is a medicare enrolled "Pediatrics" physician in Jacksonville, Florida. Her current practice location is 120 King St, Jacksonville, Florida. You can reach out to her office (for appointments etc.) via phone at (904) 760-4904.

Dr Shelly Holder Thompson is licensed to practice in Florida (license number ME38917) 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 1821054560.

Contact Information

Dr Shelly Holder Thompson, MD
120 King St,
Jacksonville, FL 32204-2410
(904) 760-4904
(904) 760-4250

Map and Direction




Physician's Profile

Full NameDr Shelly Holder Thompson
GenderFemale
SpecialityPediatrics
Location120 King St, Jacksonville, Florida
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1821054560
  • Provider Enumeration Date: 04/21/2006
  • Last Update Date: 07/21/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 6800937228
  • Enrollment ID: I20100107000595

Medical Identifiers

Medical identifiers for Dr Shelly Holder Thompson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1821054560NPI-NPPES
066208900MedicaidFL
0662089-00MedicaidFL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics ME0038917 (Florida)Secondary
208000000XPediatrics ME38917 (Florida)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. Dr Shelly Holder Thompson allows following entities to bill medicare on her behalf.
Entity NameAgape Community Health Center, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1962867762
PECOS PAC ID: 3476500695
Enrollment ID: O20050331000177
Entity NameIm Sulzbacher Center For The Homeless, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1710051354
PECOS PAC ID: 2860652641
Enrollment ID: O20130815000630

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 Shelly Holder Thompson 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 AddressPractice Location Address
Dr Shelly Holder Thompson, MD
120 King Street,
Jacksonville, FL 32204-2410

Ph: (904) 760-4904
Dr Shelly Holder Thompson, MD
120 King St,
Jacksonville, FL 32204-2410

Ph: (904) 760-4904

Reviews and Comments


Pediatrics Doctors in Jacksonville, FL

Dr. Maryam Ooja Abubakar, MD, MPH
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Medicare: Medicare Enrolled
Practice Location: 655 W 8th St, Jacksonville, FL 32209
Phone: 904-244-3508    
Dr. Mohamad Alasad Tolaymat, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 820 Prudential Dr, Ufjp Pediatric Multi-specialty Clinic, Jacksonville, FL 32207
Phone: 904-633-0920    Fax: 904-633-0921
Christopher Emanuel, MD
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Medicare: Not Enrolled in Medicare
Practice Location: 3945 San Jose Park Dr, Jacksonville, FL 32217
Phone: 904-731-3530    Fax: 904-737-1548
Bridget Sharrar,
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 12276 San Jose Blvd Ste 507, Jacksonville, FL 32223
Phone: 904-288-8910    Fax: 904-288-8912
Kelly Marie Summers, ARNP
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Medicare: Medicare Enrolled
Practice Location: 807 Childrens Way, Jacksonville, FL 32207
Phone: 904-697-3600    
Yekaterina Jones, D.O.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 841 Prudential Dr Ste 1130, Jacksonville, FL 32207
Phone: 904-633-4199    Fax: 904-633-4188
Dr. Ronald P Carzoli Jr., MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 1800 Barrs St, St Vincent's Medical Center, Jacksonville, FL 32204
Phone: 904-308-7994    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.