Mr Jason Fordyce, PMHNP-BC - Medicare Nurse Practitioner in Villa Rica, GA

Mr Jason Fordyce, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Villa Rica, Georgia. His current practice location is 307 Old Stone Rd, Villa Rica, Georgia. You can reach out to his office (for appointments etc.) via phone at (770) 459-8799.

Mr Jason Fordyce is licensed to practice in Georgia (license number RN223272) 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 1346816865.

Contact Information

Mr Jason Fordyce, PMHNP-BC
307 Old Stone Rd,
Villa Rica, GA 30180-1214
(770) 459-8799
Not Available

Map and Direction




Provider's Profile

Full NameMr Jason Fordyce
GenderMale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location307 Old Stone Rd, Villa Rica, Georgia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1346816865
  • Provider Enumeration Date: 06/03/2021
  • Last Update Date: 07/08/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 5890189260
  • Enrollment ID: I20220301000426

Medical Identifiers

Medical identifiers for Mr Jason Fordyce such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1346816865NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health RN223272 (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. Mr Jason Fordyce allows following entities to bill medicare on his behalf.
Entity NameGwinnett Physician Group, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1578574661
PECOS PAC ID: 9133211139
Enrollment ID: O20070822001035
Entity NameMobolaji Shalom Oyebanjo, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1922280684
PECOS PAC ID: 6204914401
Enrollment ID: O20080428000562

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 Fordyce 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 AddressPractice Location Address
Mr Jason Fordyce, PMHNP-BC
307 Old Stone Rd,
Villa Rica, GA 30180-1214

Ph: (770) 459-8799
Mr Jason Fordyce, PMHNP-BC
307 Old Stone Rd,
Villa Rica, GA 30180-1214

Ph: (770) 459-8799

Reviews and Comments


Nurse Practitioner Nurses in Villa Rica, GA

Thomas Stuckey, CRNP
Nurse Practitioner
Medicare: May Accept Medicare Assignments
Practice Location: 20 Herrell Rd, Villa Rica, GA 30180
Phone: 770-812-3294    
Jennifer Lee Roberts, FNP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 690 Dallas Hwy Ste 103, Villa Rica, GA 30180
Phone: 770-214-2800    Fax: 770-214-2803
Mrs. Alisha Michelle Schuchman, NP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 32 Wood Cir, Villa Rica, GA 30180
Phone: 770-241-9255    
William Thomas Carroll Iii, ACNPC-AG
Nurse Practitioner
Medicare: May Accept Medicare Assignments
Practice Location: 601 Dallas Hwy, Villa Rica, GA 30180
Phone: 770-812-3000    
Mrs. Sarah Joann Matheka, PMHNP-BC
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 101 Quartz Dr Ste 103, Villa Rica, GA 30180
Phone: 404-550-9494    
Steven Releford, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 262 Industrial Blvd, Villa Rica, GA 30180
Phone: 678-448-7879    
La-vonnie Joiner, PMHNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 690 Dallas Hwy Ste 201, Villa Rica, GA 30180
Phone: 678-840-8446    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.