JESSICA HEACOCK (PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1770157018

JESSICA HEACOCK (PMHNP-BC) is a healthcare provider. based in Rockford, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP-BC. They hold a License No. 4704328302 (MI). The NPI Number for JESSICA HEACOCK (PMHNP-BC) is 1770157018

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
JESSICA HEACOCK (PMHNP-BC)
NPI
1770157018
Phone
(801) 205-5715
Address
3825 WINDWOOD DR NE
Enumeration Date
19 May 2021
Last Update Date
19 May 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2021 (5 years ago)
PAC ID
2062812993
Group Practice PAC ID
6800707647
Professional Enrollment ID
I20210615002185
Address ID
MI495034526GR100XXSEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

8,106 NURSE PRACTITIONER in MI

Provider Addresses for JESSICA HEACOCK (PMHNP-BC)

  • 3825 WINDWOOD DR NE

    ROCKFORD, MI 493418515

    Phone: (801) 205-5715

    Type: Mailing

  • 100 CHERRY ST SE

    GRAND RAPIDS, MI 495034526

    Phone: (616) 965-8200

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $349.

Total Amount is formed as General ($349) + Research ($0) + Ownership ($0) = $349.

Last reported payment date: 2023-10-02 • Largest payer in this snapshot: Alkermes, Inc. ($136).

Total Amount

$349

General + Research + Ownership

Payments

6

Total payment records

General Amount

$349

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-10-02

Latest reported date

Top Companies

Largest payers in this snapshot

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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: 2021-06-15

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
I20210615002185INurse PractitionerMITBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49341)

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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: 6800707647View full group profile
NameSpecialtyState
Nurse PractitionerWA
O P T O M E T R YMI
-MI
-MI
Nurse PractitionerMI
Physician AssistantMI
Physician AssistantMI
Mental Health CounselorMI
O B S T E T R I C S/ G Y N E C O L O G YMI
-MI

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Frequently asked questions

Is there an official ID for JESSICA HEACOCK (PMHNP-BC) in U.S. healthcare records?
The official identifier for JESSICA HEACOCK (PMHNP-BC) is NPI 1770157018.
Is there an active status for JESSICA HEACOCK (PMHNP-BC)?
For scheduling context, JESSICA HEACOCK (PMHNP-BC) is shown as active in the registry.
What area of care is associated with JESSICA HEACOCK (PMHNP-BC)?
JESSICA HEACOCK (PMHNP-BC)'s record emphasizes Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Michigan is JESSICA HEACOCK (PMHNP-BC) registered?
Use Rockford, Michigan as the headline location for JESSICA HEACOCK (PMHNP-BC) here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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