Mrs Kimberly Ann Jackson, ARNP - Medicare Nurse Practitioner in Providence, KY

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Mrs Kimberly Ann Jackson, ARNP is a medicare enrolled "Nurse Practitioner - Women's Health" in Providence, Kentucky. Her current practice location is 215 E Main St, Providence, Kentucky. You can reach out to her office (for appointments etc.) via phone at (270) 667-7017.

Mrs Kimberly Ann Jackson is licensed to practice in Kentucky (license number 1086349) 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 1023135126.

Contact Information

Mrs Kimberly Ann Jackson, ARNP
215 E Main St,
Providence, KY 42450-1261
(270) 667-7017
(270) 667-9065

Map and Direction




Provider's Profile

Full NameMrs Kimberly Ann Jackson
GenderFemale
SpecialityNurse Practitioner - Women's Health
Location215 E Main St, Providence, Kentucky
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1023135126
  • Provider Enumeration Date: 03/23/2007
  • Last Update Date: 03/02/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 6406879634
  • Enrollment ID: I20060113000125

Medical Identifiers

Medical identifiers for Mrs Kimberly Ann Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1023135126NPI-NPPES
K185610OtherKYMEDICARE - RHCA
7100128660MedicaidKY

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LW0102XNurse Practitioner - Women's Health 1086349 (Kentucky)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. Mrs Kimberly Ann Jackson allows following entities to bill medicare on her behalf.
Entity NamePennyrile District Health Department
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1588781041
PECOS PAC ID: 6002854650
Enrollment ID: O20050422000959
Entity NameRegional Health Care Affiliates, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1144543349
PECOS PAC ID: 3173668274
Enrollment ID: O20100824000119
Entity NamePennyrile District Health Department
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1386761435
PECOS PAC ID: 6002854650
Enrollment ID: O20160226001351

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 Kimberly Ann Jackson 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 AddressPractice Location Address
Mrs Kimberly Ann Jackson, ARNP
Po Box 37,
Providence, KY 42450-0037

Ph: (270) 667-7017		Mrs Kimberly Ann Jackson, ARNP
215 E Main St,
Providence, KY 42450-1261

Ph: (270) 667-7017

Reviews and Comments


Nurse Practitioner Nurses in Providence, KY

Mrs. Christina Cole Chumley, APRN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 121 E Main St, Providence, KY 42450
Phone: 270-667-2023    Fax: 270-667-7518
Lori R Marrero, APRN
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 215 E Main St, Providence, KY 42450
Phone: 270-667-7017    Fax: 270-667-9065
Mrs. Jennifer J Collins, APRN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 215 E Main St, Providence, KY 42450
Phone: 270-667-7017    Fax: 270-667-9065
Winona F Lambdin, RN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 215 E Main St, Providence, KY 42450
Phone: 270-667-7017    Fax: 270-667-9065
Chelsey Aikins Bell, APRN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 215 E Main St, Providence, KY 42450
Phone: 270-667-7017    Fax: 270-667-9065
Christy Tapp, APRN, FNP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 215 E Main St, Providence, KY 42450
Phone: 270-667-7017    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.