Madison Misenheimer, OTR/L is a medicare enrolled "Occupational Therapist" provider in Jefferson City, Tennessee. She graduated from medical school in 2022 and has 4 years of diverse experience with area of expertise as Occupational Therapist In Private Practice. She is a member of the group practice Jordan C Black and her current practice location is
263 E Broadway Blvd, Jefferson City, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(865) 375-0880.
Madison Misenheimer is licensed to practice in Tennessee (license number 7416) 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 1790407104.
Healthcare Provider's Profile
| Full Name | Madison Misenheimer |
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| Gender | Female |
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| Speciality | Occupational Therapist In Private Practice |
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| Experience | 4 Years |
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| Location | 263 E Broadway Blvd, Jefferson City, Tennessee |
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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:
- Madison Misenheimer graduated from medical school in 2022
NPI Data:
- NPI Number: 1790407104
- Provider Enumeration Date: 09/13/2022
- Last Update Date: 01/07/2026
Medicare PECOS Information:
- PECOS PAC ID: 3173993177
- Enrollment ID: I20230109002755
Medical Identifiers
Medical identifiers for Madison Misenheimer such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1790407104 | NPI | - | NPPES |
| 7416 | Other | TN | LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225X00000X | Occupational Therapist | 7416 (Tennessee) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Jordan C Black | 5890117469 | 25 |
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. Madison Misenheimer allows following entities to bill medicare on her behalf.
| Provider Name | Jordan C Black |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1528569316
PECOS PAC ID: 5890117469
Enrollment ID: O20200629000595 |
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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. Madison Misenheimer 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 |
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Madison Misenheimer, OTR/L
325 W Morris Blvd Ste B,
Morristown, TN 37813-2237
Ph: (423) 375-8907 | Madison Misenheimer, OTR/L
263 E Broadway Blvd,
Jefferson City, TN 37760-2810
Ph: (865) 375-0880 |
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