Keva S Jackson, FNP-BC, PMHNP in Baltimore, MD

Keva S Jackson, FNP-BC, PMHNP is a medicare enrolled "Nurse Practitioner - Family" in Baltimore, Maryland. Her current practice location is 2300 Garrison Blvd, Baltimore, Maryland. You can reach out to her office (for appointments etc.) via phone at (443) 723-4752.

Keva S Jackson is licensed to practice in Maryland (license number R151343) 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 1144963059.

Contact Information

	Keva S Jackson, FNP-BC, PMHNP
	2300 Garrison Blvd, Baltimore, MD 21216-2335
	(443) 723-4752
	Not Available

Map and Direction

Provider's Profile

Full Name	Keva S Jackson
Gender	Female
Speciality	Nurse Practitioner - Family
Location	2300 Garrison Blvd, Baltimore, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1144963059
Provider Enumeration Date: 04/18/2022
Last Update Date: 09/20/2024

Medicare PECOS Information:

PECOS PAC ID: 5698159879
Enrollment ID: I20220907002955

Medical Identifiers

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

Identifier	Type	State	Issuer
1144963059	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	R151343 (Maryland)	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. Keva S Jackson allows following entities to bill medicare on her behalf.

Entity Name	Baltimore Healthcare And Wellness, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1306511597 PECOS PAC ID: 8628452083 Enrollment ID: O20220902000532

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. Keva S 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
Keva S Jackson, FNP-BC, PMHNP 5017 Old Court Rd, Randallstown, MD 21133-4630 Ph: (443) 392-4561	Keva S Jackson, FNP-BC, PMHNP 2300 Garrison Blvd, Baltimore, MD 21216-2335 Ph: (443) 723-4752

Reviews and Comments

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Keva S Jackson, FNP-BC, PMHNP - Medicare Nurse Practitioner in Baltimore, MD