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

Active since April 04, 2020PECOS EnrolledAccepts Medicare Assignment
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: July 19, 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 and is a graduate of Other (2019).

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
Fax(803) 883-4087
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
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

Other Names 1

Other Name (5)Ms. Kimberly Dianne Jackson Np

Other Identifiers 2

OtherAG01200075Aanp Certification Number
OtherAG01200075American Association Of Nurse Practitioners Certifying Board

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Kimberly Dianne Billie Jackson Agnp-c 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 ID5698167823
PECOS Enrollment IDI20230922001843
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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 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

The NPI number assigned to this healthcare provider is 1588293278, enumerated as an "individual" on April 04, 2020.

The provider is located at 940 MORNINGSIDE DR SUMTER, SC 29153 and the phone number is (914) 359-7442.

Clinic/Center with taxonomy code 261QC1500X and a focus in Community Health.

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.