Dr Debra Japzon Gillum, PHD in Fayetteville, NC - Medicare Psychologist Provider

Dr Debra Japzon Gillum, PHD is a medicare enrolled "Psychologist - Clinical" provider in Fayetteville, North Carolina. Her current practice location is 1540 Purdue Dr, Suite 200, Fayetteville, North Carolina. You can reach out to her office (for appointments etc.) via phone at (901) 867-8889.

Dr Debra Japzon Gillum is licensed to practice in North Carolina (license number 1708) 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 1649365503.

Contact Information

	Dr Debra Japzon Gillum, PHD
	1540 Purdue Dr, Suite 200, Fayetteville, NC 28303-5510
	(901) 867-8889
	(901) 867-8699

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Debra Japzon Gillum
Gender	Female
Speciality	Psychologist - Clinical
Location	1540 Purdue Dr, Fayetteville, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1649365503
Provider Enumeration Date: 10/04/2006
Last Update Date: 06/22/2009

Medicare PECOS Information:

PECOS PAC ID: 0042290603
Enrollment ID: I20200316000998

Medical Identifiers

Medical identifiers for Dr Debra Japzon Gillum such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1649365503	NPI	-	NPPES
6000388	Medicaid	NC
0450T	Other	NC	BCBS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	1708 (North Carolina)	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. Dr Debra Japzon Gillum allows following entities to bill medicare on her behalf.

Entity Name	Potomac Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457403099 PECOS PAC ID: 2860484094 Enrollment ID: O20040330001518

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. Dr Debra Japzon Gillum 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
Dr Debra Japzon Gillum, PHD 1540 Purdue Dr, Suite 200, Fayetteville, NC 28303-5510 Ph: (901) 867-8889	Dr Debra Japzon Gillum, PHD 1540 Purdue Dr, Suite 200, Fayetteville, NC 28303-5510 Ph: (901) 867-8889

Reviews and Comments

Psychologist in Fayetteville, NC

Dr. Mary Beth Barnes, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2300 Ramsey St, Ms 116, Fayetteville, NC 28301 Phone: 910-488-2120 Fax: 910-822-7934
Theodore W. Lane, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1540 Purdue Dr Ste 200, Fayetteville, NC 28303 Phone: 910-867-8889 Fax: 910-487-3061
Jenna Herring, Psychologist Medicare: Medicare Enrolled Practice Location: 806 Hay St, Fayetteville, NC 28305 Phone: 910-860-7008 Fax: 910-221-9006
Dr. Tiffany Nicole Gatling, PH.D. Psychologist Medicare: Medicare Enrolled Practice Location: 2300 Ramsey St, Fayetteville, NC 28301 Phone: 910-488-2120
Miss Liandra Mercedis Wheeler, LPA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2940 Breezewood Ave, Fayetteville, NC 28303 Phone: 910-827-6594 Fax: 910-827-6592
Dr. Paul J Dean, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 874 Long Iron Dr, Fayetteville, NC 28312 Phone: 910-960-7510
Mrs. Nicole O Collins, M.A. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5843 Waters Edge Dr, Fayetteville, NC 28314 Phone: 732-642-4412

Dr Debra Japzon Gillum, PHD - Medicare Psychologist in Fayetteville, NC