Brooke Revell Sansom, APRN in Blountstown, FL

Brooke Revell Sansom, APRN is a medicare enrolled "Nurse Practitioner - Family" in Blountstown, Florida. Her current practice location is 19611 Fl-20 West, Blountstown, Florida. You can reach out to her office (for appointments etc.) via phone at (850) 674-5645.

Brooke Revell Sansom is licensed to practice in Florida (license number 11015583) 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 1932741840.

Contact Information

	Brooke Revell Sansom, APRN
	19611 Fl-20 West, Blountstown, FL 32424
	(850) 674-5645
	Not Available

Map and Direction

Provider's Profile

Full Name	Brooke Revell Sansom
Gender	Female
Speciality	Nurse Practitioner - Family
Location	19611 Fl-20 West, Blountstown, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1932741840
Provider Enumeration Date: 10/11/2019
Last Update Date: 11/12/2021

Medicare PECOS Information:

PECOS PAC ID: 1153714902
Enrollment ID: I20220131002098

Medical Identifiers

Medical identifiers for Brooke Revell Sansom such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1932741840	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	9435556 (Florida)	Secondary
363LF0000X	Nurse Practitioner - Family	11015583 (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. Brooke Revell Sansom allows following entities to bill medicare on her behalf.

Entity Name	Florida Department Of Health
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1932149531 PECOS PAC ID: 3072424282 Enrollment ID: O20050924000116

Entity Name	Florida Department Of Health
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1548263114 PECOS PAC ID: 3072424282 Enrollment ID: O20100518000300

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. Brooke Revell Sansom 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
Brooke Revell Sansom, APRN 19611 Fl-20 West, Blountstown, FL 32424 Ph: (850) 674-5645	Brooke Revell Sansom, APRN 19611 Fl-20 West, Blountstown, FL 32424 Ph: (850) 674-5645

Reviews and Comments

Nurse Practitioner Nurses in Blountstown, FL

Linda S Deese, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 20370 Ne Burns Ave, Blountstown, FL 32424 Phone: 850-237-3000 Fax: 850-237-3001
Allison Nichole Tipton, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 18801 Ne Live Oak Ln, Blountstown, FL 32424 Phone: 850-447-1966
Mr. Michael B. Mckenzie, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 19611 Sr 20 W, Blountstown, FL 32424 Phone: 850-674-5645 Fax: 850-674-5420
Rita Smith, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 19611 Sr 20 W, Blountstown, FL 32424 Phone: 850-674-5645
Mrs. Hayley Sumner Nichols, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 16729 Sw Gaskin St, Blountstown, FL 32424 Phone: 850-643-8001
Mr. Robert Casey Dobson, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 20370 Ne Burns Ave, Blountstown, FL 32424 Phone: 850-674-5411
Tina Denice Dorsey, APRN-FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 20274 Central Ave W, Blountstown, FL 32424 Phone: 850-353-7689 Fax: 850-674-8889

Brooke Revell Sansom, APRN - Medicare Nurse Practitioner in Blountstown, FL