AMANDA R. JACKSON NP - NPI 1447658919 - Nurse Practitioner in Kingsport, TN

Q: What is Amanda Jackson's NPI number?

The NPI number for Amanda Jackson is 1447658919. It was assigned to this individual provider in the NPPES registry on December 15, 2014.

Q: What is Amanda Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: Is Amanda Jackson enrolled in Medicare?

No. Amanda Jackson has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Amanda Jackson was last updated on June 6, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Amanda R. Jackson Np NPPES

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

AMANDA R. JACKSON NP (NPI 1447658919) is an individual family provider in Kingsport, Tennessee, licensed in Tennessee (19521) and active in the NPI registry since December 2014. She has opted out of Medicare through January 1, 2028 and remains eligible to order and refer and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1447658919

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameAMANDA R. JACKSONCredential: NP

Location Address111 W STONE DR STE 110Kingsport, TN 37660-6027

Mailing Address1101 E Stone Dr, Suite 2Kingsport, TN 37660-3384 · (423) 224-1110 · Fax (423) 224-1130

Phone(423) 224-3701

Fax(423) 224-3709

Sole ProprietorNo

Enumeration DateDecember 15, 2014

Last NPPES UpdateJune 6, 20182 updates tracked since enumeration

✔ NPI 1447658919 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in TN · 19521

Also ListedRegistered NurseTaxonomy 163W00000X · License 182185 (TN)

111 W STONE DR STE 110, Kingsport, TN 37660

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Secondary Practice Locations 2

Location 11101 E Stone Dr, Suite 2Kingsport, TN 37660-3384 · Phone (423) 224-1110 · Fax (423) 224-1130

Location 2378 Marketplace Dr Ste 5Johnson City, TN 37604-2361 · Phone (423) 282-0751 · Fax (423) 282-1577

Other Identifiers 2

MedicaidQ010785TN

Medicaid1447658919VA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Amanda R. Jackson Np has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2026 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2026

Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37660 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

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

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 9

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

MRS. AMANDA SUSAN BURNS ARNP

Nurse Practitioner