Michelle Lynn Jackson, APRN is a medicare enrolled "Nurse Practitioner - Family" physician in Peoria, Illinois. She graduated from medical 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 Hammond Henry Dist Hospital and her current practice location is
8914 N Knoxville Ave, Peoria, Illinois. You can reach out to her office (for appointments etc.) via phone at
(309) 691-9110.
Michelle Lynn Jackson is licensed to practice in Illinois (license number 209019281) 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 1790347722.
Physician's Profile
| Full Name | Michelle Lynn 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 | 8914 N Knoxville Ave, Peoria, Illinois |
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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. |
Medical Education and Training:
- Michelle Lynn Jackson graduated from medical school in 2018
NPI Data:
- NPI Number: 1790347722
- Provider Enumeration Date: 06/29/2019
- Last Update Date: 12/14/2024
Medicare PECOS Information:
- PECOS PAC ID: 0749612554
- Enrollment ID: I20191118000138
Medical Identifiers
Medical identifiers for Michelle Lynn Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1790347722 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207Q00000X | Family Medicine | 209.019281 (Illinois) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 209019281 (Illinois) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| Hammond Henry Dist Hospital | 0143115949 | 29 |
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. Michelle Lynn Jackson allows following entities to bill medicare on her behalf.
| Entity Name | Proctor Health Systems |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1134173917 PECOS PAC ID: 3476440173 Enrollment ID: O20040227000906 |
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| Entity Name | Iowa Physicians Clinic Medical Foundation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1366425274 PECOS PAC ID: 8729992318 Enrollment ID: O20040512000055 |
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| Entity Name | Hammond Henry Dist Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1457344491 PECOS PAC ID: 0143115949 Enrollment ID: O20071211000175 |
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| Entity Name | Hammond Henry Dist Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1629517313 PECOS PAC ID: 0143115949 Enrollment ID: O20170511000385 |
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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. Michelle Lynn 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 |
Michelle Lynn Jackson, APRN 8914 N Knoxville Ave, Peoria, IL 61615-1410 Ph: (309) 691-9110 | Michelle Lynn Jackson, APRN 8914 N Knoxville Ave, Peoria, IL 61615-1410 Ph: (309) 691-9110 |
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