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SALLY ANN DAVIS-JACKSON MSW, PLMHP, CSW
NPI 1225672371
Social Worker - Clinical in Bassett, NE

Active since November 01, 2019PECOS EnrolledAccepts Medicare Assignment
202 E HIGHWAY 20, BASSETT, NE 68714(402) 684-2908 Get Directions Write a Review

NPPES record last updated: November 1, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Sally Ann Davis-jackson Msw, Plmhp, Csw NPPES

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

SALLY ANN DAVIS-JACKSON MSW, PLMHP, CSW (NPI 1225672371) is an individual clinical provider in Bassett, Nebraska, licensed in Nebraska (12003) and active in the NPI registry since November 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1225672371
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSALLY ANN DAVIS-JACKSONCredential: MSW, PLMHP, CSW
Location Address202 E HIGHWAY 20Bassett, NE 68714-6052
Mailing AddressPo Box 26Bassett, NE 68714-0026 · (402) 684-2908 · Fax (402) 913-3454
Phone(402) 684-2908
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateNovember 1, 2019
✔ NPI 1225672371 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NE · 12003
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
202 E HIGHWAY 20, Bassett, NE 68714
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Sunflower Health Plan, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Sally Ann Davis-jackson Msw, Plmhp, Csw 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 ID5799128849
PECOS Enrollment IDI20240206002985
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.

Medicare Billing Reassignment

Medicare enrollment records show Sally Davis-jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Midwest Country Clinic LLC
0.2 mi
Mental Health
407 S CLARK ST
Bassett, NE 68714
  • Reassigned Medicare billing, Nebraska enrollment
  • 6 clinicians in this Medicare group
NPI 1417155433 (402) 684-2908

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 68714 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
$0.00 typical visit price
range $52.69 – $160.21
Typical copayment $0.00 (range $13.17 – $40.05)
Most-billed visit code NA
Established Patient
$66.00 typical visit price
range $16.90 – $131.25
Typical copayment $16.50 (range $4.22 – $32.81)
Most-billed visit code 99213
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 2

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

BRITTANY DEVALL HEYDEN
Nurse Practitioner (Family)
202 E HIGHWAY 20
BASSETT, NE 68714
Rock County (402) 302-0090
MURLENE NOLLMEYER OSBURN APRN
Nurse Practitioner (Psychiatric/Mental Health)
202 E HIGHWAY 20
BASSETT, NE 68714
Rock County (402) 382-0911

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 Sally Davis-jackson's NPI number?

The NPI number for Sally Davis-jackson is 1225672371. It was assigned to this individual provider in the NPPES registry on November 1, 2019.

Where is Sally Davis-jackson located?

Sally Davis-jackson practices at 202 E Highway 20, Bassett, NE 68714. The listed phone number is (402) 684-2908.

What is Sally Davis-jackson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Sally Davis-jackson enrolled in Medicare?

Yes. Sally Davis-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.

Which organization bills Medicare for Sally Davis-jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sally Davis-jackson reassigns Medicare benefits to Midwest Country Clinic LLC (Bassett, NE). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sally Davis-jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sally Davis-jackson accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Sunflower Health Plan, Blue Cross and Blue Shield of Nebraska and Oscar Insurance Company and 1 other insurer list Sally Davis-jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sally Davis-jackson was last updated on November 1, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.