Mrs Jacqueline Ruth Sullivan-ogg, ARNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Underwood, Iowa. Her current practice location is
401 Highway St, Underwood, Iowa. You can reach out to her office (for appointments etc.) via phone at
(712) 566-9148.
Mrs Jacqueline Ruth Sullivan-ogg is licensed to practice in Iowa (license number A-082459) 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 1932153632.
Provider's Profile
| Full Name | Mrs Jacqueline Ruth Sullivan-ogg |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 401 Highway St, Underwood, Iowa |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1932153632
- Provider Enumeration Date: 05/19/2006
- Last Update Date: 06/18/2008
Medicare PECOS Information:
- PECOS PAC ID: 4284613894
- Enrollment ID: I20040716000999
Medical Identifiers
Medical identifiers for Mrs Jacqueline Ruth Sullivan-ogg such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1932153632 | NPI | - | NPPES |
| P00338315 | Other | IA | RAILROAD MEDICARE |
| 0498329 | Medicaid | IA | |
| 270478 | Other | IA | MEDICARE ID |
| 110194 | Other | NE | ARNP LICENSE |
| A- 082459 | Other | IA | ARNP LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LF0000X | Nurse Practitioner - Family | A-082459 (Iowa) | 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 Jacqueline Ruth Sullivan-ogg allows following entities to bill medicare on her behalf.
| Entity Name | Underwood Family Practice |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1902935554
PECOS PAC ID: 6709889884
Enrollment ID: O20060809000445 |
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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 Jacqueline Ruth Sullivan-ogg 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 |
|---|
Mrs Jacqueline Ruth Sullivan-ogg, ARNP-BC
401 Highway St, Po Box 218,
Underwood, IA 51576-0218
Ph: (712) 566-9148 | Mrs Jacqueline Ruth Sullivan-ogg, ARNP-BC
401 Highway St,
Underwood, IA 51576
Ph: (712) 566-9148 |
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