Mrs Jaclyn Nicole Botterbush, APRN, FNP-BC - Medicare Nurse Practitioner in Cleveland, TN

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Mrs Jaclyn Nicole Botterbush, APRN, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Cleveland, Tennessee. Her current practice location is 110 Dunhill Pl Nw, Cleveland, Tennessee. You can reach out to her office (for appointments etc.) via phone at (423) 476-2212.

Mrs Jaclyn Nicole Botterbush is licensed to practice in Tennessee (license number 33639) 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 1043917297.

Contact Information

Mrs Jaclyn Nicole Botterbush, APRN, FNP-BC
110 Dunhill Pl Nw,
Cleveland, TN 37311-3866
(423) 476-2212
(423) 476-7022

Map and Direction




Provider's Profile

Full NameMrs Jaclyn Nicole Botterbush
GenderFemale
SpecialityNurse Practitioner - Family
Location110 Dunhill Pl Nw, Cleveland, Tennessee
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1043917297
  • Provider Enumeration Date: 02/08/2023
  • Last Update Date: 03/05/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 4183089394
  • Enrollment ID: I20230421002175

Medical Identifiers

Medical identifiers for Mrs Jaclyn Nicole Botterbush such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1043917297NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 33639 (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. Mrs Jaclyn Nicole Botterbush allows following entities to bill medicare on her behalf.
Entity NameSoutheastern Emergency Physicians Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1356379382
PECOS PAC ID: 2466364997
Enrollment ID: O20050125000997
Entity NameBlue Ridge Pulmonary Medicine, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1487601019
PECOS PAC ID: 3678586963
Enrollment ID: O20060804000044
Entity NameFast Pace Medical Clinic Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1134452865
PECOS PAC ID: 5395881841
Enrollment ID: O20091014000112

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. Mrs Jaclyn Nicole Botterbush 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
Mrs Jaclyn Nicole Botterbush, APRN, FNP-BC
110 Dunhill Pl Nw,
Cleveland, TN 37311-3866

Ph: () -		Mrs Jaclyn Nicole Botterbush, APRN, FNP-BC
110 Dunhill Pl Nw,
Cleveland, TN 37311-3866

Ph: (423) 476-2212

Reviews and Comments


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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.