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STACEY JACKSON FNP-C
NPI 1134645674
Nurse Practitioner - Family in Bedford, TX

Active since August 16, 2017PECOS EnrolledAccepts Medicare Assignment
1604 HOSPITAL PKWY STE 100, BEDFORD, TX 76022(817) 848-2880(817) 848-2890 Get Directions Write a Review

NPPES record last updated: October 30, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 13, 2019, Aug 16, 2017 (2 updates tracked since 2017).

About Stacey Jackson Fnp-c NPPES

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

STACEY JACKSON FNP-C (NPI 1134645674) is an individual family provider in Bedford, Texas, licensed in Texas (AP134528) and active in the NPI registry since August 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1134645674
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSTACEY JACKSONCredential: FNP-C
Location Address1604 HOSPITAL PKWY STE 100Bedford, TX 76022-5913
Mailing AddressPo Box 746079Atlanta, GA 30374-6079 · (817) 848-2880 · Fax (817) 848-2890
Phone(817) 848-2880
Fax(817) 848-2890
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateAugust 16, 2017
Last NPPES UpdateOctober 30, 20242 updates tracked since enumeration
NPPES CertifiedOctober 30, 2024
✔ NPI 1134645674 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 TX · AP134528
1604 HOSPITAL PKWY STE 100, Bedford, TX 76022
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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

Stacey Jackson Fnp-c 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 ID4183986920
PECOS Enrollment IDI20180315000474
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 3

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
140 services78 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
56 services45 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
30 services22 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76022 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
$87.20 typical visit price
range $56.47 – $171.07
Typical copayment $21.80 (range $14.11 – $42.76)
Most-billed visit code 99203
Established Patient
$99.68 typical visit price
range $18.18 – $139.68
Typical copayment $24.92 (range $4.54 – $34.92)
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.

Other Providers at the Same Location NPPES 4

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

LORRAINE F KREIDER M.D.
Internal Medicine
1604 HOSPITAL PKWY STE 100
BEDFORD, TX 76022
Tarrant County (817) 848-2880
SHERIF Y HANNA M.D.
Internal Medicine
1604 HOSPITAL PKWY STE 100
BEDFORD, TX 76022
Tarrant County (817) 848-2880
KRISHNAVENI BETHI M.D.
Internal Medicine
1604 HOSPITAL PKWY STE 100
BEDFORD, TX 76022
Tarrant County (817) 848-2880
SUNITHA SIRAM M.D.
Internal Medicine
1604 HOSPITAL PKWY STE 100
BEDFORD, TX 76022
Tarrant County (817) 848-2880

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacey Jackson's NPI number?

The NPI number for Stacey Jackson is 1134645674. It was assigned to this individual provider in the NPPES registry on August 16, 2017.

Where is Stacey Jackson located?

Stacey Jackson practices at 1604 Hospital Pkwy Ste 100, Bedford, TX 76022. The listed phone number is (817) 848-2880.

What is Stacey Jackson's specialty?

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

Is Stacey Jackson enrolled in Medicare?

Yes. Stacey Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Stacey Jackson was last updated on October 30, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.