BRADLEY DANIEL JACKSON (CRNA) – Certified Registered Nurse Anesthetist, NPI 1578869475

BRADLEY DANIEL JACKSON (CRNA) is a healthcare provider. based in Brewton, Alabama. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. ARNP9312860 (FL). The NPI Number for BRADLEY DANIEL JACKSON (CRNA) is 1578869475

Main info

Male
16 Years Of Experience
Accepts Medicare Assignment
Name
BRADLEY DANIEL JACKSON (CRNA)
NPI
1578869475
Phone
(251) 809-8429
Address
1301 BELLEVILLE AVE
Enumeration Date
10 February 2011
Last Update Date
25 August 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2518678061
Graduation Year
2010 (16 years ago)
PAC ID
5597946434
Group Practice PAC ID
3072558378
Professional Enrollment ID
I20200831000612
Address ID
AL364261306BR1301XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:15State licenses:1Digital endpointsOther names

5,359 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in FL

Provider Addresses for BRADLEY DANIEL JACKSON (CRNA)

  • 1301 BELLEVILLE AVE

    BREWTON, AL 364261306

    Phone: (251) 809-8429

    Type: Mailing

  • 4901 GRANDE DR

    PENSACOLA, FL 325045935

    Phone: (850) 477-7042

    Fax: (850) 474-9060

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-08-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200831000612ICertified Registered Nurse Anesthetist (Crna)ALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00811Anesthesia for other procedure on large bowel using an endoscope2929$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope2322$0
View full utilization report →

Insurance plans in this area (ZIP 36426)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3072558378View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)AL
Nurse PractitionerAL
Family PracticeKY
Family Practice, Emergency MedicineAL
Internal Medicine, Family PracticeAL
Certified Registered Nurse Anesthetist (Crna)AL
O B S T E T R I C S/ G Y N E C O L O G YFL
-AL
Nurse PractitionerAL
Family PracticeAL

Reviews

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Frequently asked questions

How do payers reference BRADLEY DANIEL JACKSON (CRNA)?
For BRADLEY DANIEL JACKSON (CRNA), use NPI 1578869475 as the unique 10-digit identifier.
Is there an active status for BRADLEY DANIEL JACKSON (CRNA)?
For scheduling context, BRADLEY DANIEL JACKSON (CRNA) is shown as active in the registry.
What kind of doctor is BRADLEY DANIEL JACKSON (CRNA)?
BRADLEY DANIEL JACKSON (CRNA) is associated with Certified Registered Nurse Anesthetist in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with BRADLEY DANIEL JACKSON (CRNA)?
Directory geography for BRADLEY DANIEL JACKSON (CRNA) centers on Brewton, Alabama.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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