Mrs Jan Sullivan Randle, FNP in Louisville, MS

Mrs Jan Sullivan Randle, FNP is a medicare enrolled "Nurse Practitioner" in Louisville, Mississippi. She graduated from nursing school in 1997 and has 27 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Choctaw Regional Medical Center and her current practice location is 14724 Highway 15 N, Louisville, Mississippi. You can reach out to her office (for appointments etc.) via phone at (662) 773-7500.

Mrs Jan Sullivan Randle is licensed to practice in Mississippi (license number R652962) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1184675134.

Contact Information

	Mrs Jan Sullivan Randle, FNP
	14724 Highway 15 N, Louisville, MS 39339-6318
	(662) 773-7500
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Jan Sullivan Randle
Gender	Female
Speciality	Nurse Practitioner
Experience	27 Years
Location	14724 Highway 15 N, Louisville, Mississippi
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mrs Jan Sullivan Randle graduated from nursing school in 1997

NPI Data:

NPI Number: 1184675134
Provider Enumeration Date: 05/15/2006
Last Update Date: 03/10/2020

Medicare PECOS Information:

PECOS PAC ID: 8820045370
Enrollment ID: I20050406000664

Medical Identifiers

Medical identifiers for Mrs Jan Sullivan Randle such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1184675134	NPI	-	NPPES
00118926	Medicaid	MS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	R652962 (Mississippi)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Sta Home Health And Hospice	Carthage, MS	Home health agency
Choctaw Regional Medical Center	Ackerman, MS	Hospital
Winston Medical Center & Swingbed	Louisville, MS	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Choctaw Regional Medical Center	2567682206	26

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 Jan Sullivan Randle allows following entities to bill medicare on her behalf.

Entity Name	Choctaw Regional Medical Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1235547878 PECOS PAC ID: 2567682206 Enrollment ID: O20141215002502

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 Jan Sullivan Randle 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 Jan Sullivan Randle, FNP 8613 Ms Highway 12, Ackerman, MS 39735-8917 Ph: (662) 285-9460	Mrs Jan Sullivan Randle, FNP 14724 Highway 15 N, Louisville, MS 39339-6318 Ph: (662) 773-7500

Reviews and Comments

Nurse Practitioner Nurses in Louisville, MS

Alyssa Cameron Whitehead, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2750 N Church Ave, Louisville, MS 39339 Phone: 662-446-9012 Fax: 662-446-9432
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Eric Leron Yarbrough, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 17550 E Main St, Louisville, MS 39339 Phone: 662-773-3503
Jessica Clark Mills, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 16569 W Main St, Louisville, MS 39339 Phone: 662-773-5704 Fax: 662-773-9463
Tasha L Hannah, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2095 S Church Ave, Louisville, MS 39339 Phone: 662-803-0415
Laken Nicole Fulcher, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 16569 W Main St, Louisville, MS 39339 Phone: 662-773-5704 Fax: 662-773-9463

Mrs Jan Sullivan Randle, FNP - Medicare Nurse Practitioner in Louisville, MS