Jennifer Blaylock, FNP is a medicare enrolled "Nurse Practitioner - Primary Care" in Polk City, Iowa. She graduated from nursing school in 2022 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice On With Life Inc, Douglas A Layton Do and her current practice location is
1010 S 3rd St, Polk City, Iowa. You can reach out to her office (for appointments etc.) via phone at
(515) 986-6426.
Jennifer Blaylock is licensed to practice in Iowa (license number A172505) 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 1316651524.
Provider's Profile
| Full Name | Jennifer Blaylock |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 4 Years |
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| Location | 1010 S 3rd St, Polk City, Iowa |
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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:
- Jennifer Blaylock graduated from nursing school in 2022
NPI Data:
- NPI Number: 1316651524
- Provider Enumeration Date: 01/11/2023
- Last Update Date: 03/25/2024
Medicare PECOS Information:
- PECOS PAC ID: 9638528425
- Enrollment ID: I20231205002357
Medical Identifiers
Medical identifiers for Jennifer Blaylock such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1316651524 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | A172505 (Iowa) | Secondary |
| 363LP2300X | Nurse Practitioner - Primary Care | A172505 (Iowa) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| On With Life Inc | 4385553965 | 5 |
| Douglas A Layton Do | 8325495294 | 2 |
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. Jennifer Blaylock allows following entities to bill medicare on her behalf.
| Entity Name | On With Life Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1336633346
PECOS PAC ID: 4385553965
Enrollment ID: O20181019001088 |
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| Entity Name | Douglas A Layton Do |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1336781855
PECOS PAC ID: 8325495294
Enrollment ID: O20231114003673 |
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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. Jennifer Blaylock 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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Jennifer Blaylock, FNP
15196 Nw 16th St,
Slater, IA 50244-8019
Ph: (515) 619-1475 | Jennifer Blaylock, FNP
1010 S 3rd St,
Polk City, IA 50226-1130
Ph: (515) 986-6426 |
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