Amy Monett-shamon Shoulders Thomas, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Bolton, Mississippi. Her current practice location is
115 W Madison St, Bolton, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(601) 866-7723.
Amy Monett-shamon Shoulders Thomas is licensed to practice in Mississippi (license number F0312107) 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 1831453091.
Provider's Profile
| Full Name | Amy Monett-shamon Shoulders Thomas |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 115 W Madison St, Bolton, Mississippi |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1831453091
- Provider Enumeration Date: 07/02/2012
- Last Update Date: 09/05/2021
Medicare PECOS Information:
- PECOS PAC ID: 3577705631
- Enrollment ID: I20130821000818
Medical Identifiers
Medical identifiers for Amy Monett-shamon Shoulders Thomas such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1831453091 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | F0312107 (Mississippi) | 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. Amy Monett-shamon Shoulders Thomas allows following entities to bill medicare on her behalf.
| Entity Name | Signify Health Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1689158487
PECOS PAC ID: 3274895263
Enrollment ID: O20210323002802 |
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| Entity Name | Community Care Health Network Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1619368842
PECOS PAC ID: 8527324151
Enrollment ID: O20210520000556 |
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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. Amy Monett-shamon Shoulders Thomas 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 |
|---|
Amy Monett-shamon Shoulders Thomas, FNP-C
115 W Madison St,
Bolton, MS 39041-3209
Ph: (601) 866-7723 | Amy Monett-shamon Shoulders Thomas, FNP-C
115 W Madison St,
Bolton, MS 39041-3209
Ph: (601) 866-7723 |
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