Marilou Reyes Jack, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD26013 Issued in OR

Practice address

4800 Hospital Parkway
Beatrice, NE 68310-6906

Phone

(402) 228-3344

NPI assigned

Jan 26, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Beatrice Community Hospital & Health Center Inc

  • Emergency Medicine Physician
  • Beatrice, NE
  • NPI 1922111855

  Pediatrics

  Medicare reassignment NPD
• Beatrice Community Hospital & Health Center Inc

  • Clinic/Center
  • Beatrice, NE
  • NPI 1013092592
  NPD (past)
• Beatrice Community Hospital & Health Center Inc

  • Critical Access Hospital
  • Beatrice, NE
  • NPI 1184642894
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348444800000",
    "number": "1669442075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 HOSPITAL PARKWAY",
            "city": "BEATRICE",
            "state": "NE",
            "postal_code": "683106906",
            "telephone_number": "402-228-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 HOSPITAL PARKWAY",
            "city": "BEATRICE",
            "state": "NE",
            "postal_code": "683106906",
            "telephone_number": "402-228-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACK",
        "first_name": "MARILOU",
        "middle_name": "REYES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2012-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD26013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Husa
• Addison Schramm Huss, RN
• Shelley Huston
• Vantashia Marie Hynes
• Inline Healing
• Molly James
• Diana Jamison
• Dawn Jeardoe, RN BSN
• Charity Jensen
• John H McDougall OD PC

• Pediatrics Physician in Beatrice, NE
• Providers in Beatrice, NE by specialty
• Pediatrics Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.