Jessica Diane Membrillo, AGACNP-BC in Canton, GA

Jessica Diane Membrillo, AGACNP-BC is a medicare enrolled "Registered Nurse" in Canton, Georgia. Her current practice location is 145 Riverstone Ter Ste 101, Canton, Georgia. You can reach out to her office (for appointments etc.) via phone at (770) 450-4807.

Jessica Diane Membrillo is licensed to practice in Georgia (license number RN259993) 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 1235880634.

Contact Information

	Jessica Diane Membrillo, AGACNP-BC
	145 Riverstone Ter Ste 101, Canton, GA 30114-5327
	(770) 450-4807
	Not Available

Map and Direction

Provider's Profile

Full Name	Jessica Diane Membrillo
Gender	Female
Speciality	Registered Nurse
Location	145 Riverstone Ter Ste 101, Canton, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1235880634
Provider Enumeration Date: 01/17/2022
Last Update Date: 10/30/2023

Medicare PECOS Information:

PECOS PAC ID: 1951759802
Enrollment ID: I20231203000159

Medical Identifiers

Medical identifiers for Jessica Diane Membrillo such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1235880634	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	RN259993 (Georgia)	Secondary
163W00000X	Registered Nurse	RN259993 (Georgia)	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. Jessica Diane Membrillo allows following entities to bill medicare on her behalf.

Entity Name	Nova Spine And Pain Care Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1225759236 PECOS PAC ID: 7517334246 Enrollment ID: O20221109000339

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. Jessica Diane Membrillo 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
Jessica Diane Membrillo, AGACNP-BC 606 Forest Pine Dr, Ball Ground, GA 30107-5196 Ph: (770) 608-4407	Jessica Diane Membrillo, AGACNP-BC 145 Riverstone Ter Ste 101, Canton, GA 30114-5327 Ph: (770) 450-4807

Reviews and Comments

Registered Nurse Nurses in Canton, GA

Mrs. Tiffani Amber Wilson, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 450 Northside Cherokee Blvd, Canton, GA 30115 Phone: 770-224-2000
Mr. Stephen Armstrong Ii, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 910 Sublime Trl, Canton, GA 30114 Phone: 678-558-4664
Megan Erin Mccoy, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 450 Northside Cherokee Blvd, Canton, GA 30115 Phone: 770-224-1000
Briana Howard, RN, WHNP Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 116 Holly Pl, Canton, GA 30115 Phone: 770-744-8822
Rebekah Davis, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 191 Lamar Haley Pkwy, Canton, GA 30114 Phone: 770-704-1600 Fax: 770-704-1610
Kristen Rinaldi, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 378 Winston Cir, Canton, GA 30114 Phone: 404-409-9617
Matthew Delaney Hinkle, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 148 Stonegate Ln, Canton, GA 30114 Phone: 678-386-6393

Jessica Diane Membrillo, AGACNP-BC - Medicare Registered Nurse in Canton, GA