Mrs Jenna L Shock, MSN, APRN, PMHNP-BC in Fort Wayne, IN

Mrs Jenna L Shock, MSN, APRN, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Fort Wayne, Indiana. Her current practice location is 1690 Broadway, Building 19, Suite 10, Fort Wayne, Indiana. You can reach out to her office (for appointments etc.) via phone at (260) 200-4940.

Mrs Jenna L Shock is licensed to practice in Indiana (license number 71009466A) 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 1255984738.

Contact Information

	Mrs Jenna L Shock, MSN, APRN, PMHNP-BC
	1690 Broadway, Building 19, Suite 10, Fort Wayne, IN 46802-2012
	(260) 200-4940
	(949) 404-6540

Map and Direction

Provider's Profile

Full Name	Mrs Jenna L Shock
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	1690 Broadway, Fort Wayne, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1255984738
Provider Enumeration Date: 07/23/2019
Last Update Date: 05/19/2023

Medicare PECOS Information:

PECOS PAC ID: 3870825805
Enrollment ID: I20191024001723

Medical Identifiers

Medical identifiers for Mrs Jenna L Shock such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1255984738	NPI	-	NPPES
300031451	Medicaid	IN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	71009466A (Indiana)	Primary
163WP0808X	Registered Nurse - Psychiatric/mental Health	28184986A (Indiana)	Secondary

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 Jenna L Shock allows following entities to bill medicare on her behalf.

Entity Name	Cameron Memorial Community Hospital Inc
Entity Type	Part A Provider - Critical Access Hospital
Entity Identifiers	NPI Number: 1386683316 PECOS PAC ID: 9234020835 Enrollment ID: O20060622000002

Entity Name	Shock Therapy Group Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1538869532 PECOS PAC ID: 6406394352 Enrollment ID: O20240809003852

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 Jenna L Shock 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 Jenna L Shock, MSN, APRN, PMHNP-BC 1690 Broadway, Building 19, Suite 10, Fort Wayne, IN 46802-2012 Ph: (260) 200-4940	Mrs Jenna L Shock, MSN, APRN, PMHNP-BC 1690 Broadway, Building 19, Suite 10, Fort Wayne, IN 46802-2012 Ph: (260) 200-4940

Reviews and Comments

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Mrs Jenna L Shock, MSN, APRN, PMHNP-BC - Medicare Nurse Practitioner in Fort Wayne, IN