Ms Shavonne Jackson, NP - Medicare Nurse Practitioner in Colonial Heights, VA

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Ms Shavonne Jackson, NP is a medicare enrolled "Nurse Practitioner - Family" in Colonial Heights, Virginia. Her current practice location is 524 Southpark Blvd, Colonial Heights, Virginia. You can reach out to her office (for appointments etc.) via phone at (804) 504-7980.

Ms Shavonne Jackson is licensed to practice in Virginia (license number 0024185612) 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 1356052971.

Contact Information

Ms Shavonne Jackson, NP
524 Southpark Blvd,
Colonial Heights, VA 23834-3609
(804) 504-7980
(804) 554-5387

Map and Direction




Provider's Profile

Full NameMs Shavonne Jackson
GenderFemale
SpecialityNurse Practitioner - Family
Location524 Southpark Blvd, Colonial Heights, Virginia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1356052971
  • Provider Enumeration Date: 12/06/2022
  • Last Update Date: 07/10/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 0840695201
  • Enrollment ID: I20230329002291

Medical Identifiers

Medical identifiers for Ms Shavonne Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1356052971NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 0024185612 (Virginia)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. Ms Shavonne Jackson allows following entities to bill medicare on her behalf.
Entity NameMid-atlantic Kidney Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1700855228
PECOS PAC ID: 7113821513
Enrollment ID: O20031126000043

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. Ms Shavonne 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
Ms Shavonne Jackson, NP
524 Southpark Blvd,
Colonial Heights, VA 23834-3609

Ph: (804) 504-7980		Ms Shavonne Jackson, NP
524 Southpark Blvd,
Colonial Heights, VA 23834-3609

Ph: (804) 504-7980

Reviews and Comments


Nurse Practitioner Nurses in Colonial Heights, VA

Dr. Jessy A Nwuba, DNP, FNP-BC
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 3611 Boulevard, Colonial Heights, VA 23834
Phone: 571-523-5479    Fax: 804-374-8889
Mrs. Megan Sinclair Harvey, FNP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 131 Jennick Dr, Colonial Heights, VA 23834
Phone: 804-526-5888    
Samantha N Taylor, NP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 524 Southpark Blvd, Colonial Heights, VA 23834
Phone: 804-504-7980    Fax: 804-554-5387
Mrs. Stacey Renee Troublefield, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 524 Southpark Blvd, Colonial Heights, VA 23834
Phone: 804-504-7980    Fax: 804-554-5387
Cynthia Frey, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 671 Southpark Blvd, Colonial Heights, VA 23834
Phone: 866-607-7734    
Jamie L Matlick, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 445 Charles H Dimmock Pkwy Ste 100, Colonial Heights, VA 23834
Phone: 804-520-1764    Fax: 804-616-4221
Brittani Danielle Jessup, FNP-BC
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 3628 Boulevard, Colonial Heights, VA 23834
Phone: 804-526-5850    

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.