Mrs Kelly Jackson, RN, FNP-C - Medicare Nurse Practitioner in San Augustine, TX

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Mrs Kelly Jackson, RN, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in San Augustine, Texas. She graduated from nursing school in 2016 and has 8 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Oliver Street 5.01(a) Inc and her current practice location is 606 W Columbia St, San Augustine, Texas. You can reach out to her office (for appointments etc.) via phone at (936) 275-2940.

Mrs Kelly Jackson is licensed to practice in Texas (license number AP132765) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1033653431.

Contact Information

Mrs Kelly Jackson, RN, FNP-C
606 W Columbia St,
San Augustine, TX 75972-1709
(936) 275-2940
(936) 275-2954

Map and Direction




Provider's Profile

Full NameMrs Kelly Jackson
GenderFemale
SpecialityNurse Practitioner
Experience8 Years
Location606 W Columbia St, San Augustine, Texas
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mrs Kelly Jackson graduated from nursing school in 2016
  NPI Data:
  • NPI Number: 1033653431
  • Provider Enumeration Date: 12/05/2016
  • Last Update Date: 12/05/2016
  Medicare PECOS Information:
  • PECOS PAC ID: 2365727625
  • Enrollment ID: I20170329000176

Medical Identifiers

Medical identifiers for Mrs Kelly Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1033653431NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family AP132765 (Texas)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Oliver Street 5.01(a) Inc0042464125144

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 Kelly Jackson allows following entities to bill medicare on her behalf.
Entity NameBaylor St Lukes Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1740485879
PECOS PAC ID: 9133213192
Enrollment ID: O20070920000863
Entity NameOliver Street 5.01(a) Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457695413
PECOS PAC ID: 0042464125
Enrollment ID: O20130128000189
Entity NameTexas Quick Care Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1730570581
PECOS PAC ID: 0749585396
Enrollment ID: O20160219001463

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 Kelly 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
Mrs Kelly Jackson, RN, FNP-C
109 Woodruff Ln,
San Augustine, TX 75972-2637

Ph: () -		Mrs Kelly Jackson, RN, FNP-C
606 W Columbia St,
San Augustine, TX 75972-1709

Ph: (936) 275-2940

Reviews and Comments


Nurse Practitioner Nurses in San Augustine, TX

Chivas Paul Guillote, APRN, FNP, AGACNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 511 Hospital Street, Emergency Department, San Augustine, TX 75972
Phone: 936-275-3446    
Sharon Kay Oglesbee, RN-FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 504 E Hospital St, San Augustine, TX 75972
Phone: 936-275-9716    Fax: 936-275-9059
Lisa Michelle Lane,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 200 E Livingston St, San Augustine, TX 75972
Phone: 322-759-9109    
Christina Watson, NP
Nurse Practitioner
Medicare: May Accept Medicare Assignments
Practice Location: 606 W Columbia St, San Augustine, TX 75972
Phone: 936-275-2940    Fax: 936-275-2954
Mrs. Stacie L Edwards, APRN, FNP-C
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 504 E. Hospital Street, San Augustine, TX 75972
Phone: 936-275-9716    

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.