CLANTRELLE JACKSON
NPI 1447060702
Nurse Practitioner - Psychiatric/Mental Health in Aurora, CO

Q: What is Clantrelle Jackson's NPI number?

The NPI number for Clantrelle Jackson is 1447060702. It was assigned to this individual provider in the NPPES registry on January 9, 2025.

Q: What is Clantrelle Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since January 09, 2025PECOS EnrolledAccepts Medicare Assignment

2101 S BLACKHAWK ST STE 240, AURORA, CO 80014(501) 613-7863(580) 297-9105 Get Directions Write a Review

NPPES record last updated: January 9, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Clantrelle Jackson NPPES

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

CLANTRELLE JACKSON (NPI 1447060702) is an individual psychiatric/mental health provider in Aurora, Colorado, licensed in Florida (APRN11035553) and active in the NPI registry since January 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1447060702

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameCLANTRELLE JACKSON

Location Address2101 S BLACKHAWK ST STE 240Aurora, CO 80014-1475

Mailing Address2101 S Blackhawk St Ste 240Aurora, CO 80014-1475 · (501) 613-7863 · Fax (580) 297-9105

Phone(501) 613-7863

Fax(580) 297-9105

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateJanuary 9, 2025

NPPES CertifiedJanuary 9, 2025

✔ NPI 1447060702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in FL · APRN11035553

2101 S BLACKHAWK ST STE 240, Aurora, CO 80014

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Cigna HealthCare of Florida, Inc., Florida Blue (BlueCross BlueShield FL) 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

Clantrelle Jackson 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 ID42722597

PECOS Enrollment IDI20250620003679

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 Reassignments

Medicare enrollment records show Clantrelle Jackson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Nxpath Psychiatry LLC

1,650 mi

Psychiatry

1605 NW FEDERAL HWY
Stuart, FL 34994

Reassigned Medicare billing, Florida enrollment
24 clinicians in this Medicare group

NPI 1134992688 (772) 480-5860

Senior Living Memory Health, Inc.

1,709 mi

Clinical

16853 NE 2ND AVE STE 304
North Miami Beach, FL 33162

Reassigned Medicare billing, Florida enrollment
148 clinicians in this Medicare group

NPI 1851847834 (786) 414-6666

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 80014 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

$89.43 typical visit price

range $58.06 – $174.82

Typical copayment $22.35 (range $14.51 – $43.70)

Most-billed visit code 99203

Established Patient

$102.03 typical visit price

range $18.88 – $142.79

Typical copayment $25.50 (range $4.72 – $35.69)

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 20

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

MEGAN CULLEN MSED, LPC

Counselor (Professional)