Kelley J Jackson, WHNP in Placerville, CA - Medicare Nurse Practitioner

Kelley J Jackson, WHNP is a medicare enrolled "Nurse Practitioner - Women's Health" in Placerville, California. Her current practice location is 1095 Marshall Way, Placerville, California. You can reach out to her office (for appointments etc.) via phone at (530) 344-5470.

Kelley J Jackson is licensed to practice in California (license number 95026533) 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 1558044644.

Contact Information

	Kelley J Jackson, WHNP
	1095 Marshall Way, Placerville, CA 95667-5722
	(530) 344-5470
	Not Available

Map and Direction

Provider's Profile

Full Name	Kelley J Jackson
Gender	Female
Speciality	Nurse Practitioner - Women's Health
Location	1095 Marshall Way, Placerville, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1558044644
Provider Enumeration Date: 08/08/2023
Last Update Date: 08/08/2023

Medicare PECOS Information:

PECOS PAC ID: 1658734603
Enrollment ID: I20230824000975

Medical Identifiers

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

Identifier	Type	State	Issuer
1558044644	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LW0102X	Nurse Practitioner - Women's Health	95026533 (California)	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. Kelley J Jackson allows following entities to bill medicare on her behalf.

Entity Name	Marshall Medical Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1962506097 PECOS PAC ID: 7517875859 Enrollment ID: O20031208001095

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. Kelley J 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
Kelley J Jackson, WHNP 1550 Iron Point Rd Apt 1312, Folsom, CA 95630-7814 Ph: (916) 202-8490	Kelley J Jackson, WHNP 1095 Marshall Way, Placerville, CA 95667-5722 Ph: (530) 344-5470

Reviews and Comments

Nurse Practitioner Nurses in Placerville, CA

Elizabeth Weissbart Wasik, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4340 Golden Center Dr Ste B, Placerville, CA 95667 Phone: 530-621-7700
Lacey Etienne Neufeld, DNP, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1095 Marshall Way # 100, Placerville, CA 95667 Phone: 530-626-2920
Ashley Witherspoon, DNP, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4212 Missouri Flat Rd, Placerville, CA 95667 Phone: 530-621-7700
Sharon D Stone, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 905 Spring St, Placerville, CA 95667 Phone: 530-626-8300 Fax: 530-626-7617
Sheila Dupuis Fleege, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1590 Carson Rd, Placerville, CA 95667 Phone: 530-642-8409
Mrs. Kathryn Ann Sullivan, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1095 Marshall Way, 2nd Floor, Placerville, CA 95667 Phone: 530-626-6155
Mary Louise Giska, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4341 Golden Center Dr, Suite B, Placerville, CA 95667 Phone: 530-621-3600 Fax: 530-748-0325

Kelley J Jackson, WHNP - Medicare Nurse Practitioner in Placerville, CA