KIMBERLY HATCH JACKSON (ARNP) – Family Nurse Practitioner, NPI 1215171798
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for KIMBERLY HATCH JACKSON (ARNP)
140 SW VIRGINIA CIR
PO BOX 1806
MAYO, FL 320664064
Phone: (386) 294-1321
Fax: (386) 294-3876
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 95 Open Payments records for all available years, with a total value of $1,597.
Total Amount is formed as General ($1,597) + Research ($0) + Ownership ($0) = $1,597.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Lilly USA, LLC ($410).
Total Amount
$1,597
General + Research + Ownership
Payments
95
Total payment records
General Amount
$1,597
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $410 |
| PFIZER INC. | $209 |
| Novo Nordisk Inc | $174 |
| AstraZeneca Pharmaceuticals LP | $82 |
| Novartis Pharmaceuticals Corporation | $81 |
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: 2009-07-24
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090724000377 | I | Nurse Practitioner | FL | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32066)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | FL | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| - | FL | |
| Nurse Practitioner | FL | |
| Family Practice | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL |
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