Jackelyn Marie Wiser, APRN- FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Goodfellow Afb, Texas. She graduated from nursing school in 2019 and has 7 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Shannon Clinic, The West Texas Rehabilitation Center and her current practice location is
271 Ft Richardson Ave, Goodfellow Afb, Texas. You can reach out to her office (for appointments etc.) via phone at
(325) 654-5391.
Jackelyn Marie Wiser is licensed to practice in Texas (license number 1103582) 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 1669170908.
Provider's Profile
| Full Name | Jackelyn Marie Wiser |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 7 Years |
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| Location | 271 Ft Richardson Ave, Goodfellow Afb, Texas |
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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. |
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Medical Education and Training:
- Jackelyn Marie Wiser graduated from nursing school in 2019
NPI Data:
- NPI Number: 1669170908
- Provider Enumeration Date: 02/16/2023
- Last Update Date: 07/21/2025
Medicare PECOS Information:
- PECOS PAC ID: 3274077045
- Enrollment ID: I20240703002397
Medical Identifiers
Medical identifiers for Jackelyn Marie Wiser such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1669170908 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 1103582 (Texas) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Shannon Clinic | 0840103727 | 465 |
| The West Texas Rehabilitation Center | 2860301215 | 376 |
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. Jackelyn Marie Wiser allows following entities to bill medicare on her behalf.
| Entity Name | Shannon Clinic |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1770587149
PECOS PAC ID: 0840103727
Enrollment ID: O20031222000702 |
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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. Jackelyn Marie Wiser 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 |
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Jackelyn Marie Wiser, APRN- FNP-BC
3150 Appaloosa Cir,
San Angelo, TX 76901-5225
Ph: (325) 747-2292 | Jackelyn Marie Wiser, APRN- FNP-BC
271 Ft Richardson Ave,
Goodfellow Afb, TX 76908
Ph: (325) 654-5391 |
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