Terri Jackson, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" physician in Saint Louis, Missouri. Her current practice location is
3015 N Ballas Rd, Saint Louis, Missouri. You can reach out to her office (for appointments etc.) via phone at
(314) 996-5330.
Terri Jackson is licensed to practice in Missouri (license number 126514) 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 1023080199.
Physician's Profile
| Full Name | Terri Jackson |
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| Gender | Female |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 3015 N Ballas Rd, Saint Louis, Missouri |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1023080199
- Provider Enumeration Date: 02/03/2006
- Last Update Date: 08/22/2017
Medicare PECOS Information:
- PECOS PAC ID: 6507816949
- Enrollment ID: I20050125000008
Medical Identifiers
Medical identifiers for Terri Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1023080199 | NPI | - | NPPES |
| 918437401 | Medicaid | MO | |
| P00161434 | Other | MO | RAILROAD MEDICARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207L00000X | Anesthesiology | 126514 (Missouri) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 126514 (Missouri) | 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. Terri Jackson allows following entities to bill medicare on her behalf.
| Entity Name | Ballas Anesthesia Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1306894241
PECOS PAC ID: 5092615310
Enrollment ID: O20040112000519 |
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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. Terri 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 |
|---|
Terri Jackson, CRNA
3015 N Ballas Rd,
Saint Louis, MO 63131-2329
Ph: (314) 996-5330 | Terri Jackson, CRNA
3015 N Ballas Rd,
Saint Louis, MO 63131-2329
Ph: (314) 996-5330 |
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