Ms Lisa Lanette Jackson, APN is a medicare enrolled "Nurse Practitioner - Family" in Lewisville, Arkansas. Her current practice location is
1117 Chestnut St, Lewisville, Arkansas. You can reach out to her office (for appointments etc.) via phone at
(870) 921-5781.
Ms Lisa Lanette Jackson is licensed to practice in Arkansas (license number A02932 ANP) 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 1497828826.
Provider's Profile
| Full Name | Ms Lisa Lanette Jackson |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 1117 Chestnut St, Lewisville, Arkansas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1497828826
- Provider Enumeration Date: 11/15/2006
- Last Update Date: 05/29/2015
Medicare PECOS Information:
- PECOS PAC ID: 2961508486
- Enrollment ID: I20070430000557
Medical Identifiers
Medical identifiers for Ms Lisa Lanette Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1497828826 | NPI | - | NPPES |
| 202614758 | Medicaid | AR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | A02932 ANP (Arkansas) | 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. Ms Lisa Lanette Jackson allows following entities to bill medicare on her behalf.
| Entity Name | Cabun Rural Health Services, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1912946807
PECOS PAC ID: 9133029234
Enrollment ID: O20040113000620 |
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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. Ms Lisa Lanette 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 |
|---|
Ms Lisa Lanette Jackson, APN
1117 Chestnut,
Lewisville, AR 71845-1117
Ph: (870) 921-5781 | Ms Lisa Lanette Jackson, APN
1117 Chestnut St,
Lewisville, AR 71845
Ph: (870) 921-5781 |
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