KORY JACKSON (NP) – Gerontology Nurse Practitioner, NPI 1669823068
Gerontology Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
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Provider Addresses for KORY JACKSON (NP)
Subway, 900, Main Street, Peoria, Peoria County, Illinois, 61602, United States
STE 100
PEORIA, IL 616021005
Phone: (309) 672-4908
Type: Mailing
13685 DOCTORS WAY STE 170
FORT MYERS, FL 339124337
Phone: (239) 343-0629
Fax: (239) 343-0625
Type: Location
PO BOX 2147
FORT MYERS, FL 339022147
Phone: (239) 343-0629
Fax: (239) 343-0625
Type: Mailing
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: 2023-07-11
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 |
|---|---|---|---|---|
| I20230711001920 | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 496 | 132 | $0 |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 82 | 76 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 77 | 76 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 35 | 35 | $0 |
| 99316 | Nursing facility discharge management, more than 30 minutes | 18 | 18 | $0 |
Insurance plans in this area (ZIP 61602)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| R H E U M A T O L O G Y | FL | |
| Nurse Practitioner | FL | |
| Critical Care (Intensivists), Pediatric Medicine | FL | |
| General Surgery | MI | |
| N E U R O L O G Y | MO | |
| Medical Genetics And Genomics | MI | |
| Nurse Practitioner | FL | |
| Family Practice | FL | |
| General Surgery | FL | |
| Family Practice | FL |
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