Mariah Bacon, in Shepherdstown, WV - Medicare Nurse Practitioner

Mariah Bacon, is a medicare enrolled "Nurse Practitioner - Family" in Shepherdstown, West Virginia. Her current practice location is 301 N King St., Shepherdstown, West Virginia. You can reach out to her office (for appointments etc.) via phone at (304) 876-5000.

Mariah Bacon is licensed to practice in Virginia (license number 0024190164) 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 1083459853.

Contact Information

	Mariah Bacon,
	301 N King St., Shepherdstown, WV 25443
	(304) 876-5000
	Not Available

Map and Direction

Provider's Profile

Full Name	Mariah Bacon
Gender	Female
Speciality	Nurse Practitioner - Family
Location	301 N King St., Shepherdstown, West Virginia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1083459853
Provider Enumeration Date: 06/25/2024
Last Update Date: 06/25/2024

Medicare PECOS Information:

PECOS PAC ID: 4284165671
Enrollment ID: I20241009003952

Medical Identifiers

Medical identifiers for Mariah Bacon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1083459853	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	0024190164 (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. Mariah Bacon allows following entities to bill medicare on her behalf.

Entity Name	Valley Regional Enterprises, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1235178591 PECOS PAC ID: 0446164495 Enrollment ID: O20040715001410

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. Mariah Bacon 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
Mariah Bacon, 301 N King St., Shepherdstown, WV 25443 Ph: () -	Mariah Bacon, 301 N King St., Shepherdstown, WV 25443 Ph: (304) 876-5000

Reviews and Comments

Nurse Practitioner Nurses in Shepherdstown, WV

Sarah Amato, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 149 Trough Bend Ln, Shepherdstown, WV 25443 Phone: 912-678-5703
Rebecca Baldwin Fuller, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 80 Maddex Dr, Shepherdstown, WV 25443 Phone: 304-876-9422
Leslie Danielle Baugher Stine, CRNP - FAMILY Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 60 Maclaine Way, Shepherdstown, WV 25443 Phone: 304-876-6343
Christine La Porte Palank, RN, MS, ANP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: Shepherd Univ Student Health Services, E King St, Shepherdstown, WV 25443 Phone: 304-876-5161 Fax: 304-876-5509
Kalilou Djobo, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 301 S King St, Shepherdstown, WV 25443 Phone: 304-876-5000
Kerry A Tucker, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4781 Kearneysville Pike, Shepherdstown, WV 25443 Phone: 304-876-3500

Mariah Bacon, - Medicare Nurse Practitioner in Shepherdstown, WV