Destiny Grace Broom, FNP in Mccomb, MS - Medicare Nurse Practitioner

Destiny Grace Broom, FNP is a medicare enrolled "Nurse Practitioner - Family" in Mccomb, Mississippi. Her current practice location is 134 Marion Ave, Mccomb, Mississippi. You can reach out to her office (for appointments etc.) via phone at (601) 300-8252.

Destiny Grace Broom is licensed to practice in Mississippi (license number 906701) 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 1982446225.

Contact Information

	Destiny Grace Broom, FNP
	134 Marion Ave, Mccomb, MS 39648-3620
	(601) 300-8252
	Not Available

Map and Direction

Provider's Profile

Full Name	Destiny Grace Broom
Gender	Female
Speciality	Nurse Practitioner - Family
Location	134 Marion Ave, Mccomb, Mississippi
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1982446225
Provider Enumeration Date: 06/08/2024
Last Update Date: 10/01/2024

Medicare PECOS Information:

PECOS PAC ID: 2860937455
Enrollment ID: I20240708002019

Medical Identifiers

Medical identifiers for Destiny Grace Broom such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1982446225	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	906701 (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. Destiny Grace Broom allows following entities to bill medicare on her behalf.

Entity Name	Neuro Care Of Louisiana, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073962528 PECOS PAC ID: 0143514083 Enrollment ID: O20210629003095

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. Destiny Grace Broom 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
Destiny Grace Broom, FNP 134 Marion Ave, Mccomb, MS 39648-3620 Ph: (985) 805-2555	Destiny Grace Broom, FNP 134 Marion Ave, Mccomb, MS 39648-3620 Ph: (601) 300-8252

Reviews and Comments

Nurse Practitioner Nurses in Mccomb, MS

Mrs. Betty Richardson, CNFP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 421 Marion Ave, Mccomb, MS 39648 Phone: 601-684-6891 Fax: 601-249-3834
Micah Kennedy Craft, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 309 Llewellyn Ave, Mccomb, MS 39648 Phone: 601-682-7623
Mrs. Mary Thornton, CFNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 300 Rawls Dr, Ste 1200, Mccomb, MS 39648 Phone: 601-249-4710 Fax: 601-249-4716
William Jason Bass, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 215 Marion Ave, Mccomb, MS 39648 Phone: 601-249-5500 Fax: 954-367-8523
Ms. Robin Bass Spring, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 220 Scott Dr, Mccomb, MS 39648 Phone: 601-680-0371
Sunja Tate, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 300 Rawls Drive, Suite 100, Mccomb, MS 39649 Phone: 601-684-7623 Fax: 877-795-9891
Kosheya Johnson, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 300 Rawls Dr Ste 100, Mccomb, MS 39648 Phone: 601-684-2481 Fax: 601-684-2488

Destiny Grace Broom, FNP - Medicare Nurse Practitioner in Mccomb, MS