GLORIA J. JACKSON FNP - NPI 1245213354 - Nurse Practitioner in Collinsville, MS

Q: What is Gloria Jackson's NPI number?

The NPI number for Gloria Jackson is 1245213354. It was assigned to this individual provider in the NPPES registry on November 22, 2005.

Q: What is Gloria 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 Gloria Jackson was last updated on November 6, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Gloria J. Jackson Fnp NPPES

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

GLORIA J. JACKSON FNP (NPI 1245213354) is an individual family provider in Collinsville, Mississippi, licensed in Mississippi (R715654) and active in the NPI registry since November 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245213354

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameGLORIA J. JACKSONCredential: FNP

Location Address9097 COLLINSVILLE RDCollinsville, MS 39325-9779

Mailing AddressPo Box 2106Meridian, MS 39302-2106 · (601) 703-4282 · Fax (601) 703-4597

Phone(601) 626-8874

Fax(601) 626-8592

Sole ProprietorNo

Enumeration DateNovember 22, 2005

Last NPPES UpdateNovember 6, 2013

✔ NPI 1245213354 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 MS · R715654

9097 COLLINSVILLE RD, Collinsville, MS 39325

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Other Identifiers 5

Other730-15594Blue Cross Of Al

Medicare UPINQ49469

Medicaid09573377MS

Medicare ID-Type Unspecified500001935

Medicaid891010060AL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gloria J. Jackson Fnp 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 39325 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

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

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 5

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

DR. EDWARD DANIEL HENDERSON JR. M.D.

Family Medicine