MISS STEPHANIE KAY JACKSON - NPI 1164019774 - Nurse Practitioner in Winter Haven, FL

Q: What is Stephanie Jackson's NPI number?

The NPI number for Stephanie Jackson is 1164019774. It was assigned to this individual provider in the NPPES registry on December 29, 2020.

Q: What is Stephanie 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 Stephanie Jackson was last updated on August 5, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Miss Stephanie Kay Jackson NPPES

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

MISS STEPHANIE KAY JACKSON (NPI 1164019774) is an individual family provider in Winter Haven, Florida, licensed in Florida (APRN11011834) and active in the NPI registry since December 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164019774

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMISS STEPHANIE KAY JACKSON

Location Address199 AVENUE B NWWinter Haven, FL 33881-4546

Mailing Address500 E Central AveWinter Haven, FL 33880-3094 · (863) 293-1191

Phone(863) 293-1191

Fax(863) 401-8058

Sole ProprietorNo

Enumeration DateDecember 29, 2020

Last NPPES UpdateAugust 5, 20223 updates tracked since enumeration

NPPES CertifiedAugust 5, 2022

✔ NPI 1164019774 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

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

Taxonomy Code363LF0000X

License✔ Licensed in FL · APRN11011834

Also ListedRegistered NurseTaxonomy 163W00000X · License RN9260330 (FL)

Also ListedNurse Practitioner · Acute CareTaxonomy 363LA2100X · License APRN11011834 (FL)

199 AVENUE B NW, Winter Haven, FL 33881

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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 (PECOS)

Miss Stephanie Kay Jackson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33881 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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 9

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

MARIA BELEN RIVERA-BONILLA MD

Internal Medicine