Karissa Keagan Jackson, ACNPC-AG - Medicare Nurse Practitioner in Park City, UT

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Karissa Keagan Jackson, ACNPC-AG is a medicare enrolled "Nurse Practitioner - Acute Care" in Park City, Utah. Her current practice location is 1776 Park Ave Ste 211, Park City, Utah. You can reach out to her office (for appointments etc.) via phone at (385) 464-3980.

Karissa Keagan Jackson is licensed to practice in Utah (license number 7120828-4405) 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 1164055109.

Contact Information

Karissa Keagan Jackson, ACNPC-AG
1776 Park Ave Ste 211,
Park City, UT 84060-5148
(385) 464-3980
(385) 464-3990

Map and Direction




Provider's Profile

Full NameKarissa Keagan Jackson
GenderFemale
SpecialityNurse Practitioner - Acute Care
Location1776 Park Ave Ste 211, Park City, Utah
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1164055109
  • Provider Enumeration Date: 02/18/2020
  • Last Update Date: 06/02/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 4183042666
  • Enrollment ID: I20200915002665

Medical Identifiers

Medical identifiers for Karissa Keagan Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1164055109NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LA2100XNurse Practitioner - Acute Care 7120828-4405 (Utah)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. Karissa Keagan Jackson allows following entities to bill medicare on her behalf.
Entity NameIhc Health Services Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1629260880
PECOS PAC ID: 1850209420
Enrollment ID: O20031105000079
Entity NameNeurosurgical Associates Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1477695187
PECOS PAC ID: 4587578224
Enrollment ID: O20031117000554

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. Karissa Keagan 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 AddressPractice Location Address
Karissa Keagan Jackson, ACNPC-AG
1776 Park Ave Ste 211,
Park City, UT 84060-5148

Ph: (385) 464-3980		Karissa Keagan Jackson, ACNPC-AG
1776 Park Ave Ste 211,
Park City, UT 84060-5148

Ph: (385) 464-3980

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

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