MS. COURTNEY J JACK (APRN-BC) – Family Nurse Practitioner, NPI 1336740620
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,017 NURSE PRACTITIONER in MO
Provider Addresses for MS. COURTNEY J JACK (APRN-BC)
400 SW LONGVIEW BLVD STE 280
LEES SUMMIT, MO 640812157
Phone: (816) 477-7200
Type: Location
724 SW 30TH ST
BLUE SPRINGS, MO 640153381
Phone: (816) 718-7484
Type: Location
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: 2025-04-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 9 Medicare enrollment records; no due dates published yet.
Enrollment records
9
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 |
|---|---|---|---|---|
| I20210217002174 | I | Nurse Practitioner | KS | TBD |
| I20210625002463 | I | Nurse Practitioner | MO | TBD |
| I20241211002201 | I | Nurse Practitioner | IN | TBD |
| I20241211002518 | I | Nurse Practitioner | IA | TBD |
| I20241231001234 | I | Nurse Practitioner | WI | TBD |
| I20250102000877 | I | Nurse Practitioner | OH | TBD |
| I20250224000745 | I | Nurse Practitioner | MN | TBD |
| I20250407003659 | I | Nurse Practitioner | IL | TBD |
| I20250412000080 | I | Nurse Practitioner | NE | 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 | 359 | 102 | $0 |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 346 | 104 | $0 |
| 99307 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes | 50 | 36 | $0 |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 45 | 15 | $0 |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 28 | 15 | $0 |
Insurance plans in this area (ZIP 64081)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | KS | |
| Nurse Practitioner | KS | |
| Nurse Practitioner | MO | |
| Family Practice | MO | |
| - | KS | |
| - | MO | |
| - | MO | |
| Nurse Practitioner | KS | |
| - | KS | |
| Nurse Practitioner | MO |
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