CLARK JACKSON – Certified Registered Nurse Anesthetist, NPI 1053768945
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
534 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in NE
Provider Addresses for CLARK JACKSON
2500 S 60TH ST APT 21
LINCOLN, NE 685063579
Phone: (402) 613-2633
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $135.
Total Amount is formed as General ($135) + Research ($0) + Ownership ($0) = $135.
Last reported payment date: 2024-11-06 • Largest payer in this snapshot: ABBVIE INC. ($35).
Total Amount
$135
General + Research + Ownership
Payments
8
Total payment records
General Amount
$135
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-06
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2016-07-15
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160715000967 | I | Certified Registered Nurse Anesthetist (Crna) | 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 |
|---|---|---|---|---|
| 00910 | Anesthesia for other procedure on urinary system through urethra | 74 | 63 | $0 |
| 00902 | Anesthesia for procedure on anus and rectum | 46 | 43 | $0 |
| 00918 | Anesthesia for fragmenting, manipulation and/or removal of kidney stone including use of an endoscope | 43 | 43 | $0 |
| 00912 | Anesthesia for removal of urinary bladder tumors including use of an endoscope | 29 | 26 | $0 |
| 01924 | Anesthesia for x-ray on arteries | 23 | 21 | $0 |
Insurance plans in this area (ZIP 68506)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | NE | |
| Certified Registered Nurse Anesthetist (Crna) | NE | |
| Certified Registered Nurse Anesthetist (Crna) | NE | |
| - | NE | |
| - | NE | |
| Certified Registered Nurse Anesthetist (Crna) | NE | |
| Certified Registered Nurse Anesthetist (Crna) | NE |
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