Dr William Spencer Jackson, PHD is a medicare enrolled "Psychologist - Clinical" provider in Reno, Nevada. His current practice location is
880 W 12th St, Reno, Nevada. You can reach out to his office (for appointments etc.) via phone at
(775) 982-5318.
Dr William Spencer Jackson is licensed to practice in Nevada (license number PY0264) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1366585226.
Healthcare Provider's Profile
| Full Name | Dr William Spencer Jackson |
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| Gender | Male |
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| Speciality | Psychologist - Clinical |
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| Location | 880 W 12th St, Reno, Nevada |
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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: 1366585226
- Provider Enumeration Date: 02/14/2007
- Last Update Date: 11/10/2010
Medicare PECOS Information:
- PECOS PAC ID: 8921141839
- Enrollment ID: I20100201000314
Medical Identifiers
Medical identifiers for Dr William Spencer Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1366585226 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | LADC 00248-L (Nevada) | Secondary |
| 103TC0700X | Psychologist - Clinical | 13587 (California) | Secondary |
| 103TC0700X | Psychologist - Clinical | PY0264 (Nevada) | 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. Dr William Spencer Jackson allows following entities to bill medicare on his behalf.
| Entity Name | State Of Nevada |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1760572010
PECOS PAC ID: 9234022153
Enrollment ID: O20040212000160 |
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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. Dr William Spencer 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 |
|---|
Dr William Spencer Jackson, PHD
880 W 12th St,
Reno, NV 89503-2601
Ph: (775) 746-1869 | Dr William Spencer Jackson, PHD
880 W 12th St,
Reno, NV 89503-2601
Ph: (775) 982-5318 |
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