Waylon Colby Jackson, CRNA, CPNP-AC, CCRN in Springfield, IL - Medicare Certified Registered Nurse Anesthetist (crna)

Waylon Colby Jackson, CRNA, CPNP-AC, CCRN is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Springfield, Illinois. He went to Southern Illinois University School Of Medicine and graduated in 2013 and has 11 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Memorial Medical Center and his current practice location is 701 N 1st St, Springfield, Illinois. You can reach out to his office (for appointments etc.) via phone at (217) 788-3755.

Waylon Colby Jackson is licensed to practice in Illinois (license number 209011241) 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 1548443146.

Contact Information

	Waylon Colby Jackson, CRNA, CPNP-AC, CCRN
	701 N 1st St, Springfield, IL 62781-0001
	(217) 788-3755
	Not Available

Map and Direction

Provider's Profile

Full Name	Waylon Colby Jackson
Gender	Male
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	11 Years
Location	701 N 1st St, Springfield, Illinois
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Waylon Colby Jackson attended and graduated from Southern Illinois University School Of Medicine in 2013

NPI Data:

NPI Number: 1548443146
Provider Enumeration Date: 12/06/2007
Last Update Date: 10/31/2016

Medicare PECOS Information:

PECOS PAC ID: 3375776206
Enrollment ID: I20140430001452

Medical Identifiers

Medical identifiers for Waylon Colby Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1548443146	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163WC0200X	Registered Nurse - Critical Care Medicine	2002014595 (Missouri)	Secondary
363LP0222X	Nurse Practitioner - Pediatrics, Critical Care	20071425 (Missouri)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	209011241 (Illinois)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Memorial Medical Center	Springfield, IL	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Memorial Medical Center	7315835949	115

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. Waylon Colby Jackson allows following entities to bill medicare on his behalf.

Entity Name	Memorial Medical Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1255393112 PECOS PAC ID: 7315835949 Enrollment ID: O20040713000579

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. Waylon Colby 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
Waylon Colby Jackson, CRNA, CPNP-AC, CCRN 50 Frontier Lake Dr, Springfield, IL 62707-7726 Ph: (618) 977-1719	Waylon Colby Jackson, CRNA, CPNP-AC, CCRN 701 N 1st St, Springfield, IL 62781-0001 Ph: (217) 788-3755

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Springfield, IL

Douglas Mcdonald Childs, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 800 E Carpenter St, Springfield, IL 62704 Phone: 217-525-5643 Fax: 217-544-2521
Carol A Gorden, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 701 N 1st St, Springfield, IL 62781 Phone: 217-788-3754 Fax: 217-788-7071
Ann R Larson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 701 N 1st St, Anesthesia Department, Springfield, IL 62781 Phone: 217-788-3754 Fax: 217-788-7071
Jenna Younker, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 E Carpenter St, Springfield, IL 62702 Phone: 217-525-5643 Fax: 217-544-2521
Kelsey A Wallace, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 701 N 1st St, Springfield, IL 62781 Phone: 217-788-3000
Delores A Gallo, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1025 S 6th St, Springfield, IL 62703 Phone: 217-528-7541
Larry D. Sartore, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 800 East Carpenter Street, Room 2k64, Springfield, IL 62769 Phone: 217-525-5643 Fax: 217-544-3311

Waylon Colby Jackson, CRNA, CPNP-AC, CCRN - Medicare Certified Registered Nurse Anesthetist (crna) in Springfield, IL