Cheryl Ann Countryman, is a medicare enrolled "Nurse Practitioner - Acute Care" in Tonopah, Arizona. She graduated from nursing school in 2023 and has 3 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Southeastern Physician Services Pc and her current practice location is
5122 N 382nd Ave, Tonopah, Arizona. You can reach out to her office (for appointments etc.) via phone at
(160) 237-7811.
Cheryl Ann Countryman is licensed to practice in Arizona (license number 245602) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1295593697.
Provider's Profile
| Full Name | Cheryl Ann Countryman |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 3 Years |
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| Location | 5122 N 382nd Ave, Tonopah, Arizona |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Cheryl Ann Countryman graduated from nursing school in 2023
NPI Data:
- NPI Number: 1295593697
- Provider Enumeration Date: 03/11/2024
- Last Update Date: 03/11/2024
Medicare PECOS Information:
- PECOS PAC ID: 2668997164
- Enrollment ID: I20250417000182
Medical Identifiers
Medical identifiers for Cheryl Ann Countryman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1295593697 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LA2100X | Nurse Practitioner - Acute Care | 245602 (Arizona) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Southeastern Physician Services Pc | 0042307852 | 529 |
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. Cheryl Ann Countryman allows following entities to bill medicare on her behalf.
| Entity Name | Southeastern Physician Services Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1083835441
PECOS PAC ID: 0042307852
Enrollment ID: O20090715000150 |
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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. Cheryl Ann Countryman 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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Cheryl Ann Countryman,
5122 N 382nd Ave,
Tonopah, AZ 85354-0140
Ph: (160) 237-7811 | Cheryl Ann Countryman,
5122 N 382nd Ave,
Tonopah, AZ 85354-0140
Ph: (160) 237-7811 |
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