Scotty Jackson, FNP-BC in Pauls Valley, OK - Medicare Nurse Practitioner

Scotty Jackson, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Pauls Valley, Oklahoma. His current practice location is 34550 Airline Rd, Pauls Valley, Oklahoma. You can reach out to his office (for appointments etc.) via phone at (405) 207-9238.

Scotty Jackson is licensed to practice in Oklahoma (license number 211329) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1750095980.

Contact Information

	Scotty Jackson, FNP-BC
	34550 Airline Rd, Pauls Valley, OK 73075-9337
	(405) 207-9238
	(405) 207-9240

Map and Direction

Provider's Profile

Full Name	Scotty Jackson
Gender	Male
Speciality	Nurse Practitioner - Family
Location	34550 Airline Rd, Pauls Valley, Oklahoma
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1750095980
Provider Enumeration Date: 01/11/2023
Last Update Date: 07/11/2023

Medicare PECOS Information:

PECOS PAC ID: 2163896200
Enrollment ID: I20230313002174

Medical Identifiers

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

Identifier	Type	State	Issuer
1750095980	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	R0078720 (Oklahoma)	Secondary
363LF0000X	Nurse Practitioner - Family	211329 (Oklahoma)	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. Scotty Jackson allows following entities to bill medicare on his behalf.

Entity Name	Pauls Valley Family Healthcare Aprn Fnp-bc Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1407553597 PECOS PAC ID: 1254705395 Enrollment ID: O20230313002080

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. Scotty 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
Scotty Jackson, FNP-BC 34550 Airline Rd, Pauls Valley, OK 73075-9337 Ph: (405) 207-9238	Scotty Jackson, FNP-BC 34550 Airline Rd, Pauls Valley, OK 73075-9337 Ph: (405) 207-9238

Reviews and Comments

Nurse Practitioner Nurses in Pauls Valley, OK

Ms. Shelly Rae Russeff, APRN-CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 105 N Indian Meridian Rd, Pauls Valley, OK 73075 Phone: 405-207-9800 Fax: 405-207-9898
Letitia Lynn Jackson, APRN-CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2000 W Grant Ave Ste 2, Pauls Valley, OK 73075 Phone: 405-238-3900 Fax: 405-238-3903
Micki Richardson, APRN-CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 105 N Indian Meridian Rd, Pauls Valley, OK 73075 Phone: 405-207-9800
Michelle Martin, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 106 Burr Ave, Pauls Valley, OK 73075 Phone: 405-238-4633
Mary Melinda Dennis, APRN-CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 105 N Indian Meridian Rd, Pauls Valley, OK 73075 Phone: 405-207-9800 Fax: 405-207-9898
Brett Avery Baldwin, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 415 W Guy Ave, Pauls Valley, OK 73075 Phone: 405-397-0035 Fax: 405-238-9342
Marcus Shane Wahl, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 200 Melville Dr, Pauls Valley, OK 73075 Phone: 405-224-8111 Fax: 405-825-4530

Scotty Jackson, FNP-BC - Medicare Nurse Practitioner in Pauls Valley, OK