Carol D Jackson, DDS - Medicare Dentist in Danville, IL

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Carol D Jackson, DDS is a medicare enrolled "Dentist" provider in Danville, Illinois. Her current practice location is 614 N Gilbert St, Danville, Illinois. You can reach out to her office (for appointments etc.) via phone at (217) 442-8790.

Carol D Jackson is licensed to practice in Maryland (license number 14764) 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 1649496910.

Contact Information

Carol D Jackson, DDS
614 N Gilbert St,
Danville, IL 61832-3940
(217) 442-8790
(217) 442-8780

Map and Direction




Healthcare Provider's Profile

Full NameCarol D Jackson
GenderFemale
SpecialityDentist
Location614 N Gilbert St, Danville, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1649496910
  • Provider Enumeration Date: 04/17/2007
  • Last Update Date: 09/19/2012
  Medicare PECOS Information:
  • PECOS PAC ID: 6305102286
  • Enrollment ID: I20171109000125

Medical Identifiers

Medical identifiers for Carol D Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1649496910NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
122300000XDentist 14764 (Maryland)Primary
122300000XDentist 019023180 (Illinois)Secondary

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. Carol D Jackson allows following entities to bill medicare on her behalf.
Entity NameFetter Health Care Network Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003827304
PECOS PAC ID: 9032215199
Enrollment ID: O20070507000192
Entity NameFetter Health Care Network Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1982124301
PECOS PAC ID: 9032215199
Enrollment ID: O20171228002000

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. Carol D 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
Carol D Jackson, DDS
208 Crain Highway, Southwest,
Glen Burnie, MD 21061

Ph: (310) 498-0002		Carol D Jackson, DDS
614 N Gilbert St,
Danville, IL 61832-3940

Ph: (217) 442-8790

Reviews and Comments


Dentist in Danville, IL

Mark W Anderson, DDS MS
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Practice Location: 909 N Logan Ave, Danville, IL 61832
Phone: 217-446-8696    Fax: 217-446-1969
Dr. Richard Mark Vanburk, D.M.D.
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Practice Location: 610 N Logan Ave, Danville, IL 61832
Phone: 217-442-3385    Fax: 217-442-2517
Dr. James Matthew Hardy, D.D.S.
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Medicare: Medicare Enrolled
Practice Location: 809 N Gilbert St, Danville, IL 61832
Phone: 217-442-3020    Fax: 217-442-3943
Dr. Brian Lee Secrist, D.D.S.
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Medicare: Not Enrolled in Medicare
Practice Location: 1900 E Main St, Danville, IL 61832
Phone: 217-554-5859    
Dr. Jacob S Froerer, DDS, MSD
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Practice Location: 1900 E Main St, Danville, IL 61832
Phone: 217-554-3110    
Dr. Kevin King, DMD
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Practice Location: 1010 N Gilbert St, Danville, IL 61832
Phone: 217-442-4878    
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Practice Location: 2917 N Vermilion St, Aspen Dental, Danville, IL 61832
Phone: 217-703-4701    

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.