Kenneth S Jackson, FNP is a medicare enrolled "Nurse Practitioner - Family" in Bruceton, Tennessee. He graduated from nursing school in 2012 and has 12 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Mckenzie Medical Center Pc and his current practice location is
123 Maple St, Bruceton, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(731) 586-4800.
Kenneth S Jackson is licensed to practice in Tennessee (license number 17382) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1811237001.
Provider's Profile
| Full Name | Kenneth S Jackson |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 12 Years |
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| Location | 123 Maple St, Bruceton, Tennessee |
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| Accepts Medicare Assignments | Yes. He 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:
- Kenneth S Jackson graduated from nursing school in 2012
NPI Data:
- NPI Number: 1811237001
- Provider Enumeration Date: 02/25/2013
- Last Update Date: 02/28/2014
Medicare PECOS Information:
- PECOS PAC ID: 2163663931
- Enrollment ID: I20130722000341
Medical Identifiers
Medical identifiers for Kenneth S Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1811237001 | NPI | - | NPPES |
| 3380640 | Other | TN | GROUP MEDICAID |
| 3380640 | Other | TN | GROUP MEDICARE |
| 10350I2435 | Other | TN | MEDICARE PTAN |
| Q001235 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 17382 (Tennessee) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Mckenzie Medical Center Pc | 2365427853 | 26 |
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. Kenneth S Jackson allows following entities to bill medicare on his behalf.
| Entity Name | Mckenzie Medical Center Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1700534229
PECOS PAC ID: 2365427853
Enrollment ID: O20040619000083 |
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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. Kenneth S 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 |
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Kenneth S Jackson, FNP
205 Hospital Dr, Suite A,
Mc Kenzie, TN 38201-1649
Ph: (731) 352-7907 | Kenneth S Jackson, FNP
123 Maple St,
Bruceton, TN 38317-1819
Ph: (731) 586-4800 |
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