KELLY ANN JACKSON FNP-BC
NPI 1053070110
Nurse Practitioner - Family in Sikeston, MO

Q: What is Kelly Jackson's NPI number?

The NPI number for Kelly Jackson is 1053070110. It was assigned to this individual provider in the NPPES registry on December 15, 2021. The provider is also known as Kelly Ann Davis Fnp.

Q: What is Kelly Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Jackson was last updated on December 22, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since December 15, 2021PECOS EnrolledAccepts Medicare Assignment

92.57/100

CMS Quality Rating

1012 N MAIN ST, SIKESTON, MO 63801(573) 471-0330(573) 471-0461 Get Directions Write a Review

NPPES record last updated: December 22, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 22, 2021, Dec 15, 2021 (2 updates tracked since 2021).

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About Kelly Ann Jackson Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY ANN JACKSON FNP-BC (NPI 1053070110) is an individual family provider in Sikeston, Missouri, licensed in Missouri (2021028633) and active in the NPI registry since December 2021. She is enrolled in Medicare PECOS, is affiliated with Missouri Delta Medical Center, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1053070110

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameKELLY ANN JACKSONCredential: FNP-BC

Location Address1012 N MAIN STSikeston, MO 63801-5097

Mailing AddressPo Box 801143Kansas City, MO 64180-1143 · (573) 331-5583 · Fax (573) 331-5079

Phone(573) 471-0330

Fax(573) 471-0461

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateDecember 15, 2021

Last NPPES UpdateDecember 22, 20212 updates tracked since enumeration

NPPES CertifiedDecember 22, 2021

✔ NPI 1053070110 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MO · 2021028633

1012 N MAIN ST, Sikeston, MO 63801

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Other Names 1

Professional Name (2)Kelly Ann Davis Fnp

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Ann Jackson Fnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5395136501

PECOS Enrollment IDI20211223000838

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

21 services21 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Missouri Delta Medical Center

Acute Care Hospitals · Sikeston, MO

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260113

Location1008 North Main StSikeston, MO 63801 · Scott County

Emergency services Birthing friendly

Saint Francis Medical Center

Acute Care Hospitals · Cape Girardeau, MO

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260183

Location211 St Francis DrCape Girardeau, MO 63703 · Cape Girardeau County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63801 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$93.24 typical visit price

range $16.30 – $131.05

Typical copayment $23.31 (range $4.07 – $32.76)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.57/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

85.03

Promoting Interoperability

Improvement Activities

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRITTANY LYNN DELAUGHTER FNP-C

Nurse Practitioner (Family)