Carrie Jo Farnsworth, FNP, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Black Hawk, South Dakota. Her current practice location is
8000 Black Hawk Rd Ste 4, Black Hawk, South Dakota. You can reach out to her office (for appointments etc.) via phone at
(605) 431-3388.
Carrie Jo Farnsworth is licensed to practice in South Dakota (license number CP002583) 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 1114636693.
Provider's Profile
| Full Name | Carrie Jo Farnsworth |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 8000 Black Hawk Rd Ste 4, Black Hawk, South Dakota |
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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: 1114636693
- Provider Enumeration Date: 11/23/2022
- Last Update Date: 03/04/2025
Medicare PECOS Information:
- PECOS PAC ID: 2062886963
- Enrollment ID: I20230315003099
Medical Identifiers
Medical identifiers for Carrie Jo Farnsworth such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1114636693 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | CP002583 (South Dakota) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | CP002583 (South Dakota) | 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. Carrie Jo Farnsworth allows following entities to bill medicare on her behalf.
| Entity Name | Monument Health Rapid City Hospital Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1275553463
PECOS PAC ID: 6002729506
Enrollment ID: O20070625000144 |
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| Entity Name | Mind Body Connections Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1295519213
PECOS PAC ID: 0941733505
Enrollment ID: O20241104003388 |
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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. Carrie Jo Farnsworth 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 |
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Carrie Jo Farnsworth, FNP, PMHNP
8000 Black Hawk Rd Ste 4,
Black Hawk, SD 57718-3315
Ph: (605) 431-3388 | Carrie Jo Farnsworth, FNP, PMHNP
8000 Black Hawk Rd Ste 4,
Black Hawk, SD 57718-3315
Ph: (605) 431-3388 |
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