Jaci Kate Qualls, FNP-BC in Livingston, TN - Medicare Nurse Practitioner

Jaci Kate Qualls, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Livingston, Tennessee. Her current practice location is 5751 Bradford Hicks Dr, Livingston, Tennessee. You can reach out to her office (for appointments etc.) via phone at (931) 823-3030.

Jaci Kate Qualls is licensed to practice in Tennessee (license number 38006) 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 1194536367.

Contact Information

	Jaci Kate Qualls, FNP-BC
	5751 Bradford Hicks Dr, Livingston, TN 38570-2237
	(931) 823-3030
	Not Available

Map and Direction

Provider's Profile

Full Name	Jaci Kate Qualls
Gender	Female
Speciality	Nurse Practitioner - Family
Location	5751 Bradford Hicks Dr, Livingston, Tennessee
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1194536367
Provider Enumeration Date: 01/16/2025
Last Update Date: 01/16/2025

Medicare PECOS Information:

PECOS PAC ID: 6507380714
Enrollment ID: I20250409002528

Medical Identifiers

Medical identifiers for Jaci Kate Qualls such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1194536367	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	38006 (Tennessee)	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. Jaci Kate Qualls allows following entities to bill medicare on her behalf.

Entity Name	John R Clough
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1881870418 PECOS PAC ID: 6103980305 Enrollment ID: O20090203000553

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. Jaci Kate Qualls 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
Jaci Kate Qualls, FNP-BC 5751 Bradford Hicks Dr, Livingston, TN 38570-2237 Ph: (931) 823-3030	Jaci Kate Qualls, FNP-BC 5751 Bradford Hicks Dr, Livingston, TN 38570-2237 Ph: (931) 823-3030

Reviews and Comments

Nurse Practitioner Nurses in Livingston, TN

Mrs. Lillian T Robertson, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 403 E University Street, Livingston, TN 35870 Phone: 931-403-5939 Fax: 931-403-5940
Jacinda Marie Delk, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 500 W Main St, Livingston, TN 38570 Phone: 931-823-5603 Fax: 931-823-8203
Sherri C Depriest, F.N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 521 Medical Dr, Livingston, TN 38570 Phone: 931-823-5603 Fax: 931-403-0574
Rebecca Willie Thompson, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5880 Bradford Hicks Dr, Livingston, TN 38570 Phone: 931-823-6260
Kelli Carr, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 500 W Main St, Livingston, TN 38570 Phone: 931-823-5681 Fax: 931-823-8203
Kendra Simonds, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 817 W Main St, Livingston, TN 38570 Phone: 931-219-2091

Jaci Kate Qualls, FNP-BC - Medicare Nurse Practitioner in Livingston, TN