Mrs Brandi Jackson, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Orange Park, Florida. Her current practice location is
1700 Wells Rd Ste 11, Orange Park, Florida. You can reach out to her office (for appointments etc.) via phone at
(904) 670-0810.
Mrs Brandi Jackson is licensed to practice in Florida (license number SW19231) 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 1962157479.
Healthcare Provider's Profile
Full Name | Mrs Brandi Jackson |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 1700 Wells Rd Ste 11, Orange Park, Florida |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1962157479
- Provider Enumeration Date: 02/14/2022
- Last Update Date: 12/01/2023
Medicare PECOS Information:
- PECOS PAC ID: 3577932995
- Enrollment ID: I20230424000182
Medical Identifiers
Medical identifiers for Mrs Brandi Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1962157479 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | SW19231 (Florida) | Secondary |
1041C0700X | Social Worker - Clinical | SW19231 (Florida) | 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. Mrs Brandi Jackson allows following entities to bill medicare on her behalf.
Entity Name | Grow Healthcare Group Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20210414000053 |
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Entity Name | Gateway Community Services Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1356305338 PECOS PAC ID: 7618056649 Enrollment ID: O20221207000679 |
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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. Mrs Brandi 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 |
Mrs Brandi Jackson, LCSW 194 Brentley Ln, Orange Park, FL 32065-5614 Ph: (904) 207-3207 | Mrs Brandi Jackson, LCSW 1700 Wells Rd Ste 11, Orange Park, FL 32073-2373 Ph: (904) 670-0810 |
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