Amie Kathleen Jackson, is a medicare enrolled "Nurse Practitioner - Family" provider in Piqua, Ohio. She graduated from healthcare school in 2018 and has 8 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Comprehensive Rehab Consultants Pllc and her current practice location is
1130 Garbry Rd, Piqua, Ohio. You can reach out to her office (for appointments etc.) via phone at
(513) 941-4999.
Amie Kathleen Jackson is licensed to practice in Ohio (license number APRN.CNP.023408) 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 1679053821.
Healthcare Provider's Profile
| Full Name | Amie Kathleen Jackson |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 8 Years |
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| Location | 1130 Garbry Rd, Piqua, Ohio |
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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:
- Amie Kathleen Jackson graduated from medical school in 2018
NPI Data:
- NPI Number: 1679053821
- Provider Enumeration Date: 08/17/2018
- Last Update Date: 12/13/2024
Medicare PECOS Information:
- PECOS PAC ID: 2466492681
- Enrollment ID: I20191206000348
Medical Identifiers
Medical identifiers for Amie Kathleen Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1679053821 | NPI | - | NPPES |
| 0311836 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | CDCA.176328 (Ohio) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | CDCA.179912 (Ohio) | Secondary |
| 163W00000X | Registered Nurse | RN.376287 (Ohio) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | APRN.CNP.023408 (Ohio) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Comprehensive Rehab Consultants Pllc | 6800220682 | 248 |
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. Amie Kathleen Jackson allows following entities to bill medicare on her behalf.
| Entity Name | Sunrise Treatment Center Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1992043053
PECOS PAC ID: 8628336617
Enrollment ID: O20180313001475 |
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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. Amie Kathleen 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 Address | Practice Location Address |
|---|
Amie Kathleen Jackson,
6460 Harrison Ave Ste 200,
Cincinnati, OH 45247-7958
Ph: (513) 941-4999 | Amie Kathleen Jackson,
1130 Garbry Rd,
Piqua, OH 45356-8217
Ph: (513) 941-4999 |
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