Clark Jackson, - Medicare Certified Registered Nurse Anesthetist (crna) in Lincoln, NE

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Clark Jackson, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Lincoln, Nebraska. He graduated from nursing school in 2016 and has 8 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice The Urology Center, Pc, Mid Plains Anesthesia, Llc and his current practice location is 2500 S 60th St Apt 21, Lincoln, Nebraska. You can reach out to his office (for appointments etc.) via phone at (402) 613-2633.

Clark Jackson is licensed to practice in Nebraska (license number 70693) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1053768945.

Contact Information

Clark Jackson,
2500 S 60th St Apt 21,
Lincoln, NE 68506-3579
(402) 613-2633
Not Available

Map and Direction




Provider's Profile

Full NameClark Jackson
GenderMale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience8 Years
Location2500 S 60th St Apt 21, Lincoln, Nebraska
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Clark Jackson graduated from nursing school in 2016
  NPI Data:
  • NPI Number: 1053768945
  • Provider Enumeration Date: 05/20/2016
  • Last Update Date: 05/20/2016
  Medicare PECOS Information:
  • PECOS PAC ID: 0345532057
  • Enrollment ID: I20160715000967

Medical Identifiers

Medical identifiers for Clark Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053768945NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered 70693 (Nebraska)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
The Urology Center, Pc296139683318
Mid Plains Anesthesia, Llc68002142973

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. Clark Jackson allows following entities to bill medicare on his behalf.
Entity NameMemorial Community Hospital Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1265408819
PECOS PAC ID: 0749190775
Enrollment ID: O20040202001065
Entity NameThe Urology Center, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114919875
PECOS PAC ID: 2961396833
Enrollment ID: O20040614001603
Entity NameSt Marys Community Hospital
Entity TypePart A Provider - Critical Access Hospital
Entity IdentifiersNPI Number: 1528016995
PECOS PAC ID: 7113831926
Enrollment ID: O20071128000886
Entity NameMetro Omaha Anesthesia Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1558884072
PECOS PAC ID: 1456626050
Enrollment ID: O20171009000112
Entity NameChi Health Clinic Physician Enterprise-anesthesia Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1356858419
PECOS PAC ID: 2264794569
Enrollment ID: O20180404000022
Entity NameOrthoanesthesia Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1184265274
PECOS PAC ID: 2860826443
Enrollment ID: O20200107003507
Entity NameNorthstar Anesthesia Of Nebraska Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1578187670
PECOS PAC ID: 2264857135
Enrollment ID: O20200810001420
Entity NameMid Plains Anesthesia, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1710500541
PECOS PAC ID: 6800214297
Enrollment ID: O20200917000179

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. Clark 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 AddressPractice Location Address
Clark Jackson,
2500 S 60th St Apt 21,
Lincoln, NE 68506-3579

Ph: (402) 613-2633		Clark Jackson,
2500 S 60th St Apt 21,
Lincoln, NE 68506-3579

Ph: (402) 613-2633

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Lincoln, NE

Emily Noel Stutzman, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 555 S 70th St, Lincoln, NE 68510
Phone: 402-219-8000    
Matthew C. Oliver, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 6911 Van Dorn St Ste 2, Lincoln, NE 68506
Phone: 402-489-4186    Fax: 402-489-5279
Eric Johnson, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 2900 S 70th Street, Suite # 450, Lincoln, NE 68506
Phone: 402-489-4186    Fax: 402-489-5279
Hillary Marie Bonin, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 575 S 70th St Ste 305, Lincoln, NE 68510
Phone: 402-434-5600    Fax: 402-434-5601
Priscilla Boyer, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 575 S 70th St Ste 305, Lincoln, NE 68510
Phone: 402-434-5600    Fax: 402-434-5601
Carl C Blackwood, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 5701 Lillibridge St Apt 10, Lincoln, NE 68506
Phone: 607-349-9774    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.