Mrs Tiffany Renae Jackson, FNP in Charlotte, NC

Mrs Tiffany Renae Jackson, FNP is a medicare enrolled "Nurse Practitioner - Family" in Charlotte, North Carolina. Her current practice location is 10515 Mallard Creek Rd, Charlotte, North Carolina. You can reach out to her office (for appointments etc.) via phone at (704) 547-9739.

Mrs Tiffany Renae Jackson is licensed to practice in North Carolina (license number 5011180) 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 1811470768.

Contact Information

	Mrs Tiffany Renae Jackson, FNP
	10515 Mallard Creek Rd, Charlotte, NC 28262
	(704) 547-9739
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Tiffany Renae Jackson
Gender	Female
Speciality	Nurse Practitioner - Family
Location	10515 Mallard Creek Rd, Charlotte, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1811470768
Provider Enumeration Date: 09/06/2018
Last Update Date: 11/14/2018

Medicare PECOS Information:

PECOS PAC ID: 2264779156
Enrollment ID: I20190131000327

Medical Identifiers

Medical identifiers for Mrs Tiffany Renae Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1811470768	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	5011180 (North Carolina)	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 Tiffany Renae Jackson allows following entities to bill medicare on her behalf.

Entity Name	Signify Health Medical Associates Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20191001003503

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 Tiffany Renae 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 Tiffany Renae Jackson, FNP 10515 Mallard Creek Rd, Charlotte, NC 28262-9785 Ph: (704) 547-9739	Mrs Tiffany Renae Jackson, FNP 10515 Mallard Creek Rd, Charlotte, NC 28262 Ph: (704) 547-9739

Reviews and Comments

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Mrs Tiffany Renae Jackson, FNP - Medicare Nurse Practitioner in Charlotte, NC