Jacqueline Kathy Tellez, in Bristol, VA - Medicare Nurse Practitioner

Jacqueline Kathy Tellez, is a medicare enrolled "Nurse Practitioner - Family" in Bristol, Virginia. Her current practice location is 3355 Linden Dr, Bristol, Virginia. You can reach out to her office (for appointments etc.) via phone at (423) 833-6539.

Jacqueline Kathy Tellez is licensed to practice in Virginia (license number 0024188373) 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 1790408961.

Contact Information

	Jacqueline Kathy Tellez,
	3355 Linden Dr, Bristol, VA 24202-5868
	(423) 833-6539
	Not Available

Map and Direction

Provider's Profile

Full Name	Jacqueline Kathy Tellez
Gender	Female
Speciality	Nurse Practitioner - Family
Location	3355 Linden Dr, Bristol, Virginia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1790408961
Provider Enumeration Date: 09/22/2022
Last Update Date: 02/10/2025

Medicare PECOS Information:

PECOS PAC ID: 3173993151
Enrollment ID: I20230109001750

Medical Identifiers

Medical identifiers for Jacqueline Kathy Tellez such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1790408961	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	0000031726 (Tennessee)	Secondary
363LF0000X	Nurse Practitioner - Family	0024188373 (Virginia)	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. Jacqueline Kathy Tellez allows following entities to bill medicare on her behalf.

Entity Name	Southeastern Physician Services Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1083835441 PECOS PAC ID: 0042307852 Enrollment ID: O20071025000571

Entity Name	Fast Pace Medical Clinic Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1134452865 PECOS PAC ID: 5395881841 Enrollment ID: O20091014000112

Entity Name	Recover Together Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1346736758 PECOS PAC ID: 7810247533 Enrollment ID: O20201112002625

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. Jacqueline Kathy Tellez 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
Jacqueline Kathy Tellez, 5948 Wildlife Cir, Piney Flats, TN 37686-2937 Ph: (423) 833-6539	Jacqueline Kathy Tellez, 3355 Linden Dr, Bristol, VA 24202-5868 Ph: (423) 833-6539

Reviews and Comments

Nurse Practitioner Nurses in Bristol, VA

Samantha Joline Fox, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 300 Moore St Ste B, Bristol, VA 24201 Phone: 276-591-5448
Jessica N Bembry, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 743 Island Rd, Bristol, VA 24201 Phone: 276-469-4200
Chase Weaver, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 103 North St Ste A, Bristol, VA 24201 Phone: 423-844-5300 Fax: 423-844-5310
Susan K Johnson, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 300 W Valley Dr, Bristol, VA 24201 Phone: 276-466-1600 Fax: 276-466-2800
Teresa A Roatsey, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 103 North St, Bristol, VA 24201 Phone: 423-844-6000 Fax: 423-844-5090
Kathy Lynne Sharp, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 349 Island Rd, Bristol, VA 24201 Phone: 276-469-4200 Fax: 276-469-4249
Stephanie Branham, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2195 Euclid Ave, Bristol, VA 24201 Phone: 276-669-5179 Fax: 276-466-8870

Jacqueline Kathy Tellez, - Medicare Nurse Practitioner in Bristol, VA