Wallace J Jackmon, PHD in Sioux Falls, SD - Medicare Clinical Psychologist Provider

Wallace J Jackmon, PHD is a medicare enrolled "Psychologist - Clinical" provider in Sioux Falls, South Dakota. He graduated from medical school in 2007 and has 17 years of diverse experience with area of expertise as Clinical Psychologist. He is a member of the group practice Avera Mckennan and his current practice location is 4400 W 69th St, Ste 1500, Sioux Falls, South Dakota. You can reach out to his office (for appointments etc.) via phone at (605) 322-5700.

Wallace J Jackmon is licensed to practice in South Dakota (license number 477) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1427020957.

Contact Information

	Wallace J Jackmon, PHD
	4400 W 69th St, Ste 1500, Sioux Falls, SD 57108-8170
	(605) 322-5700
	(605) 322-5704

Map and Direction

Healthcare Provider's Profile

Full Name	Wallace J Jackmon
Gender	Male
Speciality	Clinical Psychologist
Experience	17 Years
Location	4400 W 69th St, Sioux Falls, South Dakota
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Wallace J Jackmon graduated from medical school in 2007

NPI Data:

NPI Number: 1427020957
Provider Enumeration Date: 02/07/2006
Last Update Date: 10/11/2018

Medicare PECOS Information:

PECOS PAC ID: 6709896467
Enrollment ID: I20090424000148

Medical Identifiers

Medical identifiers for Wallace J Jackmon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1427020957	NPI	-	NPPES
12200	Medicaid	ND
46022474352	Medicaid	NE
854000	Other	SD	ARAZ/ AMERICA'S PPO
944611700	Medicaid	MN
0040537	Other	SD	BLUE CROSS
140M8JA	Other	MN	CC SYSTEMS/ BLUE PLUS
142415	Other	MN	UCARE
412991020844	Other	SD	PREFERRED ONE
6552790	Medicaid	SD
6570753	Medicaid	SD
800013808	Other	SD	RR MEDICARE
HP37115	Other	SD	HEALTHPARTNERS
15096	Other	SD	MIDLANDS CHOICE
20814	Other	SD	SANFORD HEALTH PLAN
3989442	Medicaid	IA
57108C003	Other	SD	WPS TRICARE
9205351	Other	SD	DAKOTACARE
040121002	Other	MN	PRIMEWEST

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	477 (South Dakota)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Avera Mckennan Hospital & University Health Center	Sioux falls, SD	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Avera Mckennan	0345157103	833

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. Wallace J Jackmon allows following entities to bill medicare on his behalf.

Entity Name	Avera Mckennan
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003389206 PECOS PAC ID: 0345157103 Enrollment ID: O20031110000117

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. Wallace J Jackmon 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
Wallace J Jackmon, PHD Po Box 86370, Sioux Falls, SD 57118-6370 Ph: (605) 322-7510	Wallace J Jackmon, PHD 4400 W 69th St, Ste 1500, Sioux Falls, SD 57108-8170 Ph: (605) 322-5700

Reviews and Comments

Psychologist in Sioux Falls, SD

Dr. Rachel Mcclure, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2501 W 22nd St, Sioux Falls, SD 57105 Phone: 605-336-3230
Dr. Thomas Charles Himler, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1100 S Cliff Ave, Sioux Falls, SD 57105 Phone: 605-332-3706
Joel Sonnichsen, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 201 E 38th St, Sioux Falls, SD 57105 Phone: 605-367-7924
Nancy Ann Johnson, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 4400 W. 69th St., Ste. 1500, Sioux Falls, SD 57108 Phone: 605-322-5700 Fax: 605-322-5704
Ashton Moody, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 201 E 38th St, Sioux Falls, SD 57105 Phone: 605-367-7924
Dr. Jennifer Kae Helkenn, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 2109 S Norton Ave, Sioux Falls, SD 57105 Phone: 605-334-2696
Brenda Michelle Lindsay Nour, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4400 W 69th St Ste 1500, Sioux Falls, SD 57108 Phone: 605-480-1482

Wallace J Jackmon, PHD - Medicare Psychologist in Sioux Falls, SD