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

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 Name	Carol D Jackson
Gender	Female
Speciality	Dentist
Location	614 N Gilbert St, Danville, Illinois
Accepts Medicare Assignments	Medicare 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.

Identifier	Type	State	Issuer
1649496910	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	14764 (Maryland)	Primary
122300000X	Dentist	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 Name	Fetter Health Care Network Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003827304 PECOS PAC ID: 9032215199 Enrollment ID: O20070507000192

Entity Name	Fetter Health Care Network Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI 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 Address	Practice 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

Dr. Karl Frank Muster, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 1010 N Gilbert St, Danville, IL 61832 Phone: 217-442-4878 Fax: 217-442-2148
Mark W Anderson, DDS MS Dentist Medicare: Not Enrolled in Medicare Practice Location: 909 N Logan Ave, Danville, IL 61832 Phone: 217-446-8696 Fax: 217-446-1969
Dr. Richard Mark Vanburk, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 610 N Logan Ave, Danville, IL 61832 Phone: 217-442-3385 Fax: 217-442-2517
Dr. Donald Craig Tigchelaar, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 1900 E Main St, Va Illiana Healthcare System, Danville, IL 61832 Phone: 217-554-4516 Fax: 217-554-4881
Dr. James Matthew Hardy, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 809 N Gilbert St, Danville, IL 61832 Phone: 217-442-3020 Fax: 217-442-3943
Dr. Jacob S Froerer, DDS, MSD Dentist Medicare: Not Enrolled in Medicare Practice Location: 1900 E Main St, Danville, IL 61832 Phone: 217-554-3110
Dr. Kevin King, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 1010 N Gilbert St, Danville, IL 61832 Phone: 217-442-4878

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