Mr Jason Engholm, FNP-BC in Fort Campbell, KY

Mr Jason Engholm, FNP-BC is a medicare enrolled "Nurse Practitioner" in Fort Campbell, Kentucky. His current practice location is 650 Joel Dr, Fort Campbell, Kentucky. You can reach out to his office (for appointments etc.) via phone at (270) 798-8400.

Mr Jason Engholm is licensed to practice in Tennessee (license number 24887) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1528540812.

Contact Information

	Mr Jason Engholm, FNP-BC
	650 Joel Dr, Fort Campbell, KY 42223-5318
	(270) 798-8400
	(270) 798-8224

Map and Direction

Provider's Profile

Full Name	Mr Jason Engholm
Gender	Male
Speciality	Nurse Practitioner
Location	650 Joel Dr, Fort Campbell, Kentucky
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1528540812
Provider Enumeration Date: 09/03/2018
Last Update Date: 04/03/2024

Medicare PECOS Information:

PECOS PAC ID: 7012250764
Enrollment ID: I20190520002880

Medical Identifiers

Medical identifiers for Mr Jason Engholm such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1528540812	NPI	-	NPPES
168920	Other	TN	RN LISCENSE
24887	Other	TN	APRN LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163WE0003X	Registered Nurse - Emergency	168920 (Tennessee)	Secondary
363L00000X	Nurse Practitioner	24887 (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. Mr Jason Engholm allows following entities to bill medicare on his behalf.

Entity Name	App Of Tennessee Hm, Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396160768 PECOS PAC ID: 5395960694 Enrollment ID: O20140630001088

Entity Name	App Of East Tennessee Hm Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1518503655 PECOS PAC ID: 6002241254 Enrollment ID: O20200115002518

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. Mr Jason Engholm 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
Mr Jason Engholm, FNP-BC 650 Joel Dr, Fort Campbell, KY 42223-5318 Ph: (270) 798-8400	Mr Jason Engholm, FNP-BC 650 Joel Dr, Fort Campbell, KY 42223-5318 Ph: (270) 798-8400

Reviews and Comments

Nurse Practitioner Nurses in Fort Campbell, KY

Mrs. Denise L Jones, CFNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 605 Joel Drive, Fort Campbell, KY 42223 Phone: 270-798-4677
Debra Jean Stubblefield, N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 650 Joel Dr, Fort Campbell, KY 42223 Phone: 270-412-8940
Mr. Tracy Lynn Saboy, MSN, ANP-BC, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 650 Joel Dr, Fort Campbell, KY 42223 Phone: 270-798-8727
Mrs. Jessica Elaine Lietz, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 650 Joel Dr, Fort Campbell, KY 42223 Phone: 270-798-8400
Laytheater Michelle Brown, NURSE PRACTITIONER Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 650 Joel Dr, Fort Campbell, KY 42223 Phone: 270-798-8400
Leslie Marvene Gallon, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 650 Joel Dr, Fort Campbell, KY 42223 Phone: 270-461-2868
Ute Poepsel, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 650 Joel Dr, Blanchfield Ach, Credentialing Office - Room 1eb01, Fort Campbell, KY 42223 Phone: 270-412-8983 Fax: 270-461-0243

Mr Jason Engholm, FNP-BC - Medicare Nurse Practitioner in Fort Campbell, KY