SHANNON JACKSON (NURSE PRACTITIONER) – Nurse Practitioner, NPI 1124526280
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for SHANNON JACKSON (NURSE PRACTITIONER)
850, Independence Avenue, Chapel Hill, Akron, Summit County, Ohio, 44310, United States
AKRON, OH 443102541
Phone: (330) 766-8277
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)
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: 2018-07-20
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 |
|---|---|---|---|---|
| I20180720001980 | I | Nurse Practitioner | OH | 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 |
|---|---|---|---|---|
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 52 | 22 | $0 |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 48 | 24 | $0 |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 44 | 23 | $0 |
| 99497 | Advance care planning, first 30 minutes | 19 | 17 | $0 |
| 99345 | Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes | 17 | 17 | $0 |
Insurance plans in this area (ZIP 44310)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OH | |
| - | OH | |
| - | OH | |
| - | OH | |
| - | OH |
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