Amanda Jackson, MHR LPC is a medicare enrolled "Case Manager/care Coordinator" provider in Oklahoma City, Oklahoma. Her current practice location is
4045 Nw 64th St Ste 520, Oklahoma City, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(405) 842-4911.
Amanda Jackson is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1760891295.
Healthcare Provider's Profile
| Full Name | Amanda Jackson |
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| Gender | Female |
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| Speciality | Case Manager/care Coordinator |
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| Location | 4045 Nw 64th St Ste 520, Oklahoma City, Oklahoma |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1760891295
- Provider Enumeration Date: 08/08/2014
- Last Update Date: 02/01/2024
Medicare PECOS Information:
- PECOS PAC ID: 0345683306
- Enrollment ID: I20240206003745
Medical Identifiers
Medical identifiers for Amanda Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1760891295 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | LPC07226 (Oklahoma) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amanda Jackson allows following entities to bill medicare on her behalf.
| Entity Name | Community Pathways Unlimited Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1659328284
PECOS PAC ID: 6608776349
Enrollment ID: O20040109001005 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amanda Jackson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Amanda Jackson, MHR LPC
4045 Nw 64th St Ste 520,
Oklahoma City, OK 73116-8608
Ph: (405) 842-4911 | Amanda Jackson, MHR LPC
4045 Nw 64th St Ste 520,
Oklahoma City, OK 73116-8608
Ph: (405) 842-4911 |
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