Chaka Jackson, in Hattiesburg, MS - Medicare Certified Registered Nurse Anesthetist (crna)

Chaka Jackson, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Hattiesburg, Mississippi. She graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Hattiesburg Clinic, Pa and her current practice location is 415 S 28th Ave, Hattiesburg, Mississippi. You can reach out to her office (for appointments etc.) via phone at (601) 261-3606.

Chaka Jackson is licensed to practice in Mississippi (license number 901694) 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 1922683580.

Contact Information

	Chaka Jackson,
	415 S 28th Ave, Hattiesburg, MS 39401-7246
	(601) 261-3606
	(601) 579-5240

Map and Direction

Provider's Profile

Full Name	Chaka Jackson
Gender	Female
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	4 Years
Location	415 S 28th Ave, Hattiesburg, Mississippi
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:

Chaka Jackson graduated from nursing school in 2020

NPI Data:

NPI Number: 1922683580
Provider Enumeration Date: 03/16/2021
Last Update Date: 09/13/2021

Medicare PECOS Information:

PECOS PAC ID: 0547678120
Enrollment ID: I20210420001874

Medical Identifiers

Medical identifiers for Chaka Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1922683580	NPI	-	NPPES
02957796	Medicaid	MS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	901694 (Mississippi)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Forrest General Hospital	Hattiesburg, MS	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Hattiesburg Clinic, Pa	5193706794	489

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. Chaka Jackson allows following entities to bill medicare on her behalf.

Entity Name	Hattiesburg Clinic Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1740213446 PECOS PAC ID: 5193706794 Enrollment ID: O20040528000685

Entity Name	Youngs Professional Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1922178599 PECOS PAC ID: 2163524992 Enrollment ID: O20141015000028

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. Chaka 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
Chaka Jackson, 415 S 28th Ave, Hattiesburg, MS 39401-7246 Ph: (601) 261-3606	Chaka Jackson, 415 S 28th Ave, Hattiesburg, MS 39401-7246 Ph: (601) 261-3606

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Hattiesburg, MS

Darvin L Sibley, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-261-3606 Fax: 601-579-5166
Jeremy Alan Vance, DNP, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-261-3606 Fax: 601-579-5240
Ms. Kimberly A.h. Sundland, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-261-3606 Fax: 601-579-5383
Mr. Corey White, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-261-3606 Fax: 601-579-5383
Daniel Attaway, DNP, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-261-3606
Brandon Scott Figueiredo, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-261-3606 Fax: 601-579-5383
Scott Evans Walker, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-261-3606 Fax: 601-579-5166

Chaka Jackson, - Medicare Certified Registered Nurse Anesthetist (crna) in Hattiesburg, MS