Mrs Jessie Black, NP is a medicare enrolled "Nurse Practitioner - Family" in Chickasaw, Alabama. She graduated from nursing school in 2022 and has 3 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Nephrology Associates Of Mobile, P.a., Nephrology Associates Of Mobile, P.a. and her current practice location is
608 Masterson Ave, Chickasaw, Alabama. You can reach out to her office (for appointments etc.) via phone at
(251) 689-6356.
Mrs Jessie Black is licensed to practice in Alabama (license number 1-095422) 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 1740903681.
Provider's Profile
| Full Name | Mrs Jessie Black |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 3 Years |
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| Location | 608 Masterson Ave, Chickasaw, Alabama |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mrs Jessie Black graduated from nursing school in 2022
NPI Data:
- NPI Number: 1740903681
- Provider Enumeration Date: 09/26/2022
- Last Update Date: 06/26/2025
Medicare PECOS Information:
- PECOS PAC ID: 3678943735
- Enrollment ID: I20230105002524
Medical Identifiers
Medical identifiers for Mrs Jessie Black such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1740903681 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | 906372 (Mississippi) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 1-095422 (Alabama) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Nephrology Associates Of Mobile, P.a. | 8729061668 | 39 |
| Nephrology Associates Of Mobile, P.a. | 8729061668 | 39 |
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 Jessie Black allows following entities to bill medicare on her behalf.
| Entity Name | Nephrology Associates Of Mobile, P.a. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1861477507
PECOS PAC ID: 8729061668
Enrollment ID: O20040610001396 |
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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 Jessie Black 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 Jessie Black, NP
608 Masterson Ave,
Chickasaw, AL 36611-1618
Ph: (251) 689-6356 | Mrs Jessie Black, NP
608 Masterson Ave,
Chickasaw, AL 36611-1618
Ph: (251) 689-6356 |
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