MRS. AMY J JACKSON (NP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1972866085
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
8,191 NURSE PRACTITIONER in IN
Provider Addresses for MRS. AMY J JACKSON (NP)
2701 W NORTH ST STE B
MUNCIE, IN 473033415
Phone: (765) 281-6920
Fax: (765) 747-4499
Type: Mailing
2701 W North St Ste B
Muncie, IN 473033415
Phone: (765) 281-6920
Fax: (765) 747-4499
Type: Location
1050 Reid Pkwy Ste 210
Richmond, IN 473741160
Phone: (765) 939-7711
Fax: (765) 939-1841
Type: Location
2210 JACKSON ST
ANDERSON, IN 460164363
Phone:
Type: Mailing
250 N SHADELAND AVE
INDIANAPOLIS, IN 462194959
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 36 Open Payments records for all available years, with a total value of $844.
Total Amount is formed as General ($844) + Research ($0) + Ownership ($0) = $844.
Last reported payment date: 2024-12-04 • Largest payer in this snapshot: Supernus Pharmaceuticals, Inc. ($228).
Total Amount
$844
General + Research + Ownership
Payments
36
Total payment records
General Amount
$844
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Supernus Pharmaceuticals, Inc. | $228 |
| GlaxoSmithKline, LLC. | $65 |
| Novo Nordisk Inc | $63 |
| Medtronic, Inc. | $51 |
| PFIZER INC. | $50 |
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: 2012-07-03
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 |
|---|---|---|---|---|
| I20120703000577 | I | Nurse Practitioner | IN | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 62 | 19 | $0 |
Insurance plans in this area (ZIP 47303)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IN | |
| Clinical Social Worker | IN | |
| Clinical Social Worker | IN | |
| Nurse Practitioner | IN | |
| Clinical Social Worker | IN | |
| Clinical Social Worker | IN | |
| Clinical Psychologist | IN | |
| P S Y C H I A T R Y | IN | |
| Clinical Social Worker | IN | |
| Nurse Practitioner | IN |
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