MRS. JACKIE GWENN TAWODA FNP
NPI 1487368049
Nurse Practitioner - Family in Pineville, KY

Q: What is Jackie Tawoda's NPI number?

The NPI number for Jackie Tawoda is 1487368049. It was assigned to this individual provider in the NPPES registry on January 9, 2023. The provider is also known as Miss Jackie Ellis.

Q: What is Jackie Tawoda'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 Jackie Tawoda was last updated on October 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 January 09, 2023PECOS EnrolledAccepts Medicare Assignment

850 RIVERVIEW AVE, PINEVILLE, KY 40977(606) 654-4526 Get Directions Write a Review

NPPES record last updated: October 21, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Mrs. Jackie Gwenn Tawoda Fnp NPPES

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

MRS. JACKIE GWENN TAWODA FNP (NPI 1487368049) is an individual family provider in Pineville, Kentucky, licensed in Kentucky (3018842) and active in the NPI registry since January 2023. She is enrolled in Medicare PECOS, is affiliated with Pineville Community Health Center, Inc, and is a graduate of Lincoln Memorial University Medical Department (2022).

NPPES Registry Identity

NPI1487368049

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMRS. JACKIE GWENN TAWODACredential: FNP

Location Address850 RIVERVIEW AVEPineville, KY 40977-1452

Mailing Address268 Sadie LnEwing, VA 24248-8797

Phone(606) 654-4526

Sole ProprietorNo

Medical School CMSLincoln Memorial University Medical DepartmentGraduated 2022

Enumeration DateJanuary 9, 2023

Last NPPES UpdateOctober 21, 2024

NPPES CertifiedOctober 21, 2024

✔ NPI 1487368049 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 KY · 3018842

850 RIVERVIEW AVE, Pineville, KY 40977

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Other Names 1

Former Name (1)Miss Jackie Ellis

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Mrs. Jackie Gwenn Tawoda Fnp 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 ID1658745401

PECOS Enrollment IDI20230320000556

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 Reassignment

Medicare enrollment records show Jackie Tawoda reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pineville Community Health Center Inc

Same address

Nurse Anesthetist, Certified Registered

850 RIVERVIEW AVE
Pineville, KY 40977

Reassigned Medicare billing, Kentucky enrollment
25 clinicians in this Medicare group

NPI 1275192924 (606) 337-3051

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

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

Pineville Community Health Center, Inc

Acute Care Hospitals · Pineville, KY

OwnershipVoluntary non-profit - Private

CMS Certification Number180154

Location850 Riverview AvenuePineville, KY 40977 · Bell County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40977 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

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

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.

PINEVILLE MEDICAL CENTER, LLC

General Acute Care Hospital