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KIMBERLY DIANNE BILLIE JACKSON AGNP-C
NPI 1588293278
Clinic/Center - Community Health in Sumter, SC

Active since April 04, 2020PECOS Enrolled
940 MORNINGSIDE DR, SUMTER, SC 29153(914) 359-7442(803) 883-4087 Get Directions Write a Review

NPPES record last updated: December 27, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 27, 2021, Apr 4, 2020 (2 updates tracked since 2020).

About Kimberly Dianne Billie Jackson Agnp-c NPPES

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

KIMBERLY DIANNE BILLIE JACKSON AGNP-C (NPI 1588293278) is an individual community health provider in Sumter, South Carolina, licensed in South Carolina (APN.23707) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1588293278
Entity TypeIndividualFemale
Primary Taxonomy261QC1500X
Provider Legal NameKIMBERLY DIANNE BILLIE JACKSONCredential: AGNP-C
Location Address940 MORNINGSIDE DRSumter, SC 29153-7724
Mailing AddressPo Box 141Sumter, SC 29151-0141 · (914) 359-7442 · Fax (803) 883-4087
Phone(914) 359-7442
Fax(803) 883-4087
Sole ProprietorYes
Enumeration DateApril 4, 2020
Last NPPES UpdateDecember 27, 20212 updates tracked since enumeration
NPPES CertifiedDecember 27, 2021
✔ NPI 1588293278 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Community HealthAmbulatory Health Care Facilities
Taxonomy Code261QC1500X
License✔ Licensed in SC · APN.23707
Also ListedClinical Medical LaboratoryTaxonomy 291U00000X · License 23707 (SC)
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License APN.23707 (SC)
940 MORNINGSIDE DR, Sumter, SC 29153
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Other Names 1

Other Name (5)Ms. Kimberly Dianne Jackson Np

Other Identifiers 2

OtherAG01200075Aanp Certification Number
OtherAG01200075American Association Of Nurse Practitioners Certifying Board

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kimberly Dianne Billie Jackson Agnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Kimberly Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Crescent Health Partners
2.7 mi
Multi-Specialty
212 BROAD STREET
Sumter, SC 29150
  • Reassigned Medicare billing, South Carolina enrollment
  • 2 clinicians in this Medicare group
NPI 1568207702 (803) 580-4747

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

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.

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
33 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29153 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
$163.84 typical visit price
range $53.57 – $163.84
Typical copayment $40.96 (range $13.39 – $40.96)
Most-billed visit code 99205
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.

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 Kimberly Jackson's NPI number?

The NPI number for Kimberly Jackson is 1588293278. It was assigned to this individual provider in the NPPES registry on April 4, 2020. The provider is also known as Ms. Kimberly Dianne Jackson Np.

Where is Kimberly Jackson located?

Kimberly Jackson practices at 940 Morningside Dr, Sumter, SC 29153. The listed phone number is (914) 359-7442.

What is Kimberly Jackson's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Community Health, with taxonomy code 261QC1500X.

Is Kimberly Jackson enrolled in Medicare?

Yes. Kimberly Jackson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kimberly Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Jackson reassigns Medicare benefits to Crescent Health Partners (Sumter, SC). 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 Kimberly Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kimberly Jackson was last updated on December 27, 2021. 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.