MRS. KELLY JACKSON (RN, FNP-C) – Family Nurse Practitioner, NPI 1033653431
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
Loading map...
Provider Addresses for MRS. KELLY JACKSON (RN, FNP-C)
606, West Columbia Street, San Augustine, San Augustine County, Texas, 75972, United States
SAN AUGUSTINE, TX 759721709
Phone: (936) 275-2940
Fax: (936) 275-2954
Type: Location
9423 S US HIGHWAY 69
HUNTINGTON, TX 759491515
Phone: (936) 955-5540
Fax: (936) 955-5541
Type: Location
109, Woodruff Lane, San Augustine, San Augustine County, Texas, 75972, United States
SAN AUGUSTINE, TX 759722637
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 168 Open Payments records for all available years, with a total value of $3,328.
Total Amount is formed as General ($3,328) + Research ($0) + Ownership ($0) = $3,328.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($562).
Total Amount
$3,328
General + Research + Ownership
Payments
168
Total payment records
General Amount
$3,328
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $562 |
| Janssen Biotech, Inc. | $547 |
| GENZYME CORPORATION | $393 |
| Novartis Pharmaceuticals Corporation | $255 |
| Regeneron Healthcare Solutions, Inc. | $247 |
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: 2017-03-29
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 |
|---|---|---|---|---|
| I20170329000176 | I | Nurse Practitioner | TX | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 2,414 | 362 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1,235 | 698 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 661 | 467 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 527 | 397 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 423 | 355 | $0 |
Insurance plans in this area (ZIP 75972)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | KY | |
| D E R M A T O L O G Y | TX | |
| D E R M A T O L O G Y | TX | |
| D E R M A T O L O G Y | TX | |
| D E R M A T O L O G Y | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| D E R M A T O L O G Y | TX | |
| D E R M A T O L O G Y | TX | |
| Physician Assistant | TX |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.