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MRS. TERESA CLOYEDETTE JACKSON CRNP
NPI 1700016300
Nurse Practitioner - Acute Care in Huntsville, AL

Active since July 17, 2009PECOS Enrolled
2780 BOB WALLACE AVE SW, HUNTSVILLE, AL 35805(256) 533-4626(256) 533-4710 Get Directions Write a Review

NPPES record last updated: August 24, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mrs. Teresa Cloyedette Jackson Crnp NPPES

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

MRS. TERESA CLOYEDETTE JACKSON CRNP (NPI 1700016300) is an individual acute care provider in Huntsville, Alabama, licensed in Alabama (1-037414) and active in the NPI registry since July 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1700016300
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameMRS. TERESA CLOYEDETTE JACKSONCredential: CRNP
Location Address2780 BOB WALLACE AVE SWHuntsville, AL 35805-4104
Mailing Address2780 Bob Wallace Ave SwHuntsville, AL 35805-4104 · (256) 533-4626 · Fax (256) 533-4710
Phone(256) 533-4626
Fax(256) 533-4710
Sole ProprietorNo
Enumeration DateJuly 17, 2009
Last NPPES UpdateAugust 24, 2021
NPPES CertifiedAugust 24, 2021
✔ NPI 1700016300 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in AL · 1-037414
2780 BOB WALLACE AVE SW, Huntsville, AL 35805
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Teresa Cloyedette Jackson Crnp 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 Teresa Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Nephrology Consultants LLC
Same address
Nephrology
2780 BOB WALLACE AVE SW, SUITE E
Huntsville, AL 35805
  • Reassigned Medicare billing, Alabama enrollment
  • 16 clinicians in this Medicare group
NPI 1699874222 (256) 533-4626

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35805 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
$81.90 typical visit price
range $52.65 – $161.63
Typical copayment $20.47 (range $13.16 – $40.40)
Most-billed visit code 99203
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
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 13

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

ALLISON NICOLE BROWN CRNP
Nurse Practitioner (Primary Care)
2780 BOB WALLACE AVE SW
HUNTSVILLE, AL 35805
Madison County (256) 705-1910
JENNIFER RENFRO CRNP
Nurse Practitioner (Acute Care)
2780 BOB WALLACE AVE SW
HUNTSVILLE, AL 35805
Madison County (256) 533-4626
DAVID JOSEPH WILHELM
Internal Medicine (Nephrology)
2780 BOB WALLACE AVE SW
HUNTSVILLE, AL 35805
Madison County (256) 533-4626
SCOTT HENNIGAR
Physician Assistant
2780 BOB WALLACE AVE SW
HUNTSVILLE, AL 35805
Madison County (256) 533-4627
DAVID G BAINS MD
Internal Medicine (Nephrology)
2780 BOB WALLACE AVE SW
HUNTSVILLE, AL 35805
Madison County (256) 533-4626
JOAN NKECHI OKWEYE CRNP
Nurse Practitioner (Family)
2780 BOB WALLACE AVE SW
HUNTSVILLE, AL 35805
Madison County (256) 658-0434
JENNIFER HOPE BAGGENSTOSS PA-C
Physician Assistant
2780 BOB WALLACE AVE SW
HUNTSVILLE, AL 35805
Madison County (256) 533-4626
CARLO GOLEZ CASTILLO D.O.
Internal Medicine (Nephrology)
2780 BOB WALLACE AVE SW
HUNTSVILLE, AL 35805
Madison County (256) 533-4626

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 Teresa Jackson's NPI number?

The NPI number for Teresa Jackson is 1700016300. It was assigned to this individual provider in the NPPES registry on July 17, 2009.

Where is Teresa Jackson located?

Teresa Jackson practices at 2780 Bob Wallace Ave SW, Huntsville, AL 35805. The listed phone number is (256) 533-4626.

What is Teresa Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Teresa Jackson enrolled in Medicare?

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

Which organization bills Medicare for Teresa Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Teresa Jackson reassigns Medicare benefits to Nephrology Consultants LLC (Huntsville, AL). 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 Teresa 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 Teresa Jackson was last updated on August 24, 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.