Breanne Jackson, APRN in Seminole, OK - Medicare Nurse Practitioner

Breanne Jackson, APRN is a medicare enrolled "Nurse Practitioner" in Seminole, Oklahoma. Her current practice location is 1602 Highway 9 E, Seminole, Oklahoma. You can reach out to her office (for appointments etc.) via phone at (405) 716-9077.

Breanne Jackson is licensed to practice in Oklahoma (license number 2197444) 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 1417788241.

Contact Information

	Breanne Jackson, APRN
	1602 Highway 9 E, Seminole, OK 74868-6618
	(405) 716-9077
	Not Available

Map and Direction

Provider's Profile

Full Name	Breanne Jackson
Gender	Female
Speciality	Nurse Practitioner
Location	1602 Highway 9 E, Seminole, Oklahoma
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1417788241
Provider Enumeration Date: 08/13/2024
Last Update Date: 01/16/2025

Medicare PECOS Information:

PECOS PAC ID: 5799226098
Enrollment ID: I20240925004280

Medical Identifiers

Medical identifiers for Breanne Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1417788241	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	219744 (Oklahoma)	Secondary
363L00000X	Nurse Practitioner	2197444 (Oklahoma)	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. Breanne Jackson allows following entities to bill medicare on her behalf.

Entity Name	Williams Medical Group Practice Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1346608809 PECOS PAC ID: 3375832157 Enrollment ID: O20181228001300

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. Breanne 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
Breanne Jackson, APRN 421 W 4th St, Stroud, OK 74079-3627 Ph: (405) 915-4726	Breanne Jackson, APRN 1602 Highway 9 E, Seminole, OK 74868-6618 Ph: (405) 716-9077

Reviews and Comments

Nurse Practitioner Nurses in Seminole, OK

Teagan Bratcher, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1602 Highway 9 E, Seminole, OK 74868 Phone: 405-716-9077
Whitney Alyse Robertson, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2403 W Wrangler Blvd, Seminole, OK 74868 Phone: 580-436-5111
Mrs. Kristen Bomboy, APRN CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2010 Boren Blvd, Seminole, OK 74868 Phone: 405-382-4507 Fax: 405-382-5269
Keyanna Renee Rawlins, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2407 W Wrangler Blvd Ste B, Seminole, OK 74868 Phone: 405-303-2012
Marah Gail Canfield, APRN-CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2401 W Wrangler Blvd, Seminole, OK 74868 Phone: 405-303-4611
Shehnaz Virani, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1200 E Wrangler Blvd, Seminole, OK 74868 Phone: 405-385-1127

Breanne Jackson, APRN - Medicare Nurse Practitioner in Seminole, OK