KIMBERLY MARIE JACKSON ACNPC-AG
NPI 1336682780
Nurse Practitioner in Conway, SC

Q: What is Kimberly Jackson's NPI number?

The NPI number for Kimberly Jackson is 1336682780. It was assigned to this individual provider in the NPPES registry on December 2, 2016.

Q: What is Kimberly Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Kimberly Jackson was last updated on July 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since December 02, 2016PECOS EnrolledAccepts Medicare Assignment

85.54/100

CMS Quality Rating

2376 CYPRESS CIR STE 300, CONWAY, SC 29526(843) 353-3460 Get Directions Write a Review

NPPES record last updated: July 20, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 20, 2022, Mar 17, 2018, Jul 3, 2017 and 1 more (4 updates tracked since 2017).

On this page

About Kimberly Marie Jackson Acnpc-ag NPPES

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

KIMBERLY MARIE JACKSON ACNPC-AG (NPI 1336682780) is an individual nurse practitioner in Conway, South Carolina, licensed in South Carolina (20986) and active in the NPI registry since December 2016. She is enrolled in Medicare PECOS, is affiliated with Conway Medical Center, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1336682780

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameKIMBERLY MARIE JACKSONCredential: ACNPC-AG

Location Address2376 CYPRESS CIR STE 300Conway, SC 29526-8995

Mailing Address210 Village Center Blvd Ste 140Myrtle Beach, SC 29579-6706 · (843) 353-3460 · Fax (843) 353-3461

Phone(843) 353-3460

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateDecember 2, 2016

Last NPPES UpdateJuly 20, 20224 updates tracked since enumeration

NPPES CertifiedJuly 20, 2022

✔ NPI 1336682780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in SC · 20986

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

2376 CYPRESS CIR STE 300, Conway, SC 29526

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Other Identifiers 1

Other20986SC · Sc Nursing Board

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include First Choice Next, Molina Healthcare, 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

Kimberly Marie Jackson Acnpc-ag 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 ID2668744947

PECOS Enrollment IDI20170822000147

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 9

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.

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

135 services131 patients

Replacement of thigh bone and hip joint with prosthesis 27130

This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.

95 services93 patients

Insertion of cage or mesh device to spine bone and disc space during spine fusion 22853

Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.

63 services29 patients

Fusion of additional segment of spine 22614

Fusion of an additional segment of the spine is a surgical procedure to join two or more vertebrae together. This is done to stabilize the spine and reduce pain or correct a deformity. The procedure involves using bone grafts, rods, or screws to secure the spine.

35 services14 patients

Fusion of lower spine bone through abdomen with partial removal of disc 22558

This procedure involves merging the bones in your lower spine through an abdominal approach. A portion of the disc, which acts like a cushion between your vertebrae, is partially removed. The goal is to alleviate back pain by limiting movement in the problem area of your spine.

20 services20 patients

Placement of stabilizing device to back, 3-6 spine bone segments 22842

This procedure involves placing a device on your back to stabilize 3-6 spine bone segments. It aids in maintaining spine alignment and reducing pain. The device is secured to the bones, providing support and promoting healing.

16 services16 patients

Hospital Affiliations CMS Care Compare

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

Conway Medical Center

Acute Care Hospitals · Conway, SC

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420049

Location300 Singleton Ridge RoadConway, SC 29526 · Horry County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29526 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

$83.18 typical visit price

range $53.57 – $163.84

Typical copayment $20.79 (range $13.39 – $40.96)

Most-billed visit code 99203

Established Patient

$95.12 typical visit price

range $16.96 – $133.52

Typical copayment $23.78 (range $4.24 – $33.38)

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.

85.54/100

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

Scored as part of a group practice

Quality

80.16

Promoting Interoperability

Improvement Activities

Cost

73.33

Other Providers at the Same Location NPPES 18

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

WILLIAM L. MILLS MD

Orthopaedic Surgery (Orthopaedic Surgery of the Spine)