JACKLYN DAWN ROSE (FNP-BC) – Family Nurse Practitioner, NPI 1700364387
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,299 NURSE PRACTITIONER in OK
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Provider Addresses for JACKLYN DAWN ROSE (FNP-BC)
East Taft Avenue, Sapulpa, Creek County, Oklahoma, 74066, United States
SAPULPA, OK 740665651
Phone: (918) 224-2222
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 39 Open Payments records for all available years, with a total value of $877.
Total Amount is formed as General ($877) + Research ($0) + Ownership ($0) = $877.
Last reported payment date: 2024-11-21 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($310).
Total Amount
$877
General + Research + Ownership
Payments
39
Total payment records
General Amount
$877
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $310 |
| AstraZeneca Pharmaceuticals LP | $160 |
| Astellas Pharma US Inc | $91 |
| ABBVIE INC. | $68 |
| Edwards Lifesciences Corporation | $33 |
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: 2018-10-15
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 |
|---|---|---|---|---|
| I20181015003094 | I | Nurse Practitioner | OK | 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 | 97 | 47 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 50 | 32 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 45 | 35 | $0 |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 40 | 20 | $0 |
| 80053 | Blood test, comprehensive group of blood chemicals | 38 | 34 | $0 |
Insurance plans in this area (ZIP 74066)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | OK | |
| Family Practice | OK | |
| Nurse Practitioner | OK | |
| Family Practice | OK | |
| Physician Assistant | AZ | |
| - | OK | |
| - | OK | |
| Nurse Practitioner | OK | |
| Nurse Practitioner | OK | |
| Nurse Practitioner | OK |
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