MR. JACKIE DALE JR. HATTEN (ARNP) – Adult Health Nurse Practitioner, NPI 1639607732
Adult Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for MR. JACKIE DALE JR. HATTEN (ARNP)
500 N WEST SHORE BLVD STE 635
TAMPA, FL 336091910
Phone: (813) 513-9493
Fax: (904) 562-3317
Type: Mailing
1918 Blanding Blvd
Jacksonville, FL 322103202
Phone: (904) 389-6954
Fax: (904) 526-3317
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 23 Open Payments records for all available years, with a total value of $433.
Total Amount is formed as General ($433) + Research ($0) + Ownership ($0) = $433.
Last reported payment date: 2024-09-17 • Largest payer in this snapshot: ABBVIE INC. ($278).
Total Amount
$433
General + Research + Ownership
Payments
23
Total payment records
General Amount
$433
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $278 |
| Gilead Sciences, Inc. | $90 |
| Regeneron Healthcare Solutions, Inc. | $25 |
| RedHill Biopharma Inc. | $14 |
| Ardelyx, Inc. | $14 |
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: 2018-01-24
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 |
|---|---|---|---|---|
| I20180124001798 | 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 33609)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| G A S T R O E N T E R O L O G Y | MO | |
| Gastroenterology, Internal Medicine | FL |
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