ANTIONETTE MARIE JACKSON
NPI 1649864885
Counselor - Mental Health in Crawfordville, FL
About Antionette Marie Jackson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANTIONETTE MARIE JACKSON (NPI 1649864885) is an individual mental health provider in Crawfordville, Florida and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Antionette Marie Jackson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Antionette Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Miami, FL 33130
- Reassigned Medicare billing, Florida enrollment
- 3,079 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CRAWFORDVILLE, FL 32327
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 Antionette Jackson's NPI number?
The NPI number for Antionette Jackson is 1649864885. It was assigned to this individual provider in the NPPES registry on March 1, 2021.
Where is Antionette Jackson located?
Antionette Jackson practices at 110 Melaleuca Dr, Crawfordville, FL 32327. The listed phone number is (850) 617-9167.
What is Antionette Jackson's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Antionette Jackson enrolled in Medicare?
Yes. Antionette Jackson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Antionette Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Antionette Jackson reassigns Medicare benefits to Grow Healthcare Group PA (Miami, FL). 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 Antionette Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Antionette Jackson accept?
Health plans from Blue Cross and Blue Shield of Texas, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Antionette Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Antionette Jackson was last updated on March 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Antionette Marie Jackson · NPI 1649864885
Mental Health provider in Crawfordville, Florida. Individual provider, active in the CMS NPPES registry since March 1, 2021.
## Identity
- **NPI:** 1649864885 (Entity type: Individual)
- **Enumerated:** March 1, 2021
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Sole proprietor:** No
## Practice location
- **Address:** 110 MELALEUCA DR, Crawfordville, FL 32327-4963
- **Phone:** (850) 617-9167
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for durable medical equipment
- **Bills Medicare through:** Grow Healthcare Group PA (NPI 1245845932, Miami, FL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 1, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1649864885) · Data from the CMS NPPES public registry.