JACKIE D SPROW CRNP
NPI 1396202743
Nurse Practitioner - Family in Coudersport, PA
About Jackie D Sprow Crnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACKIE D SPROW CRNP (NPI 1396202743) is an individual family provider in Coudersport, Pennsylvania, licensed in Pennsylvania (SP019776) and active in the NPI registry since February 2019. She is enrolled in Medicare PECOS, is affiliated with Jones Memorial Hospital, and is a graduate of Other (2018).
NPPES Registry Identity
Specialties & Licenses
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
Jackie D Sprow Crnp 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.
Medicare Billing Reassignment
Medicare enrollment records show Jackie Sprow reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Coudersport, PA 16915
- Reassigned Medicare billing, Pennsylvania enrollment
- Also billed through NPI 1093182511 (Pennsylvania)
- 54 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Jones Memorial Hospital
Acute Care Hospitals · Wellsville, NYUpmc Cole
Critical Access Hospitals · Coudersport, PAPenn Highlands Elk
Critical Access Hospitals · Saint Marys, PAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 16915 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
COUDERSPORT, PA 16915
COUDERSPORT, PA 16915
COUDERSPORT, PA 16915
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 Jackie Sprow's NPI number?
The NPI number for Jackie Sprow is 1396202743. It was assigned to this individual provider in the NPPES registry on February 21, 2019.
Where is Jackie Sprow located?
Jackie Sprow practices at 1001 E 2nd St, Coudersport, PA 16915. The listed phone number is (814) 274-5320.
What is Jackie Sprow's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Jackie Sprow enrolled in Medicare?
Yes. Jackie Sprow 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 Jackie Sprow's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jackie Sprow reassigns Medicare benefits to Charles Cole Memorial Hospital (Coudersport, PA). 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 Jackie Sprow's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Jackie Sprow affiliated with any hospitals?
According to CMS data, Jackie Sprow is affiliated with Jones Memorial Hospital, Upmc Cole and Penn Highlands Elk.
When was this NPI record last updated?
The NPPES record for Jackie Sprow was last updated on April 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Jackie D Sprow, CRNP · NPI 1396202743
Family physician in Coudersport, Pennsylvania. Individual provider, active in the CMS NPPES registry since February 21, 2019.
## Identity
- **NPI:** 1396202743 (Entity type: Individual)
- **Enumerated:** February 21, 2019
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** SP019776 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 1001 E 2ND ST, Coudersport, PA 16915-8179
- **Phone:** (814) 274-5320
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Charles Cole Memorial Hospital (NPI 1326161662, Coudersport, PA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** April 2, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1396202743) · Data from the CMS NPPES public registry.