STACEY JACKSON (FNP-C) – Family Nurse Practitioner, NPI 1134645674
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
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Provider Addresses for STACEY JACKSON (FNP-C)
Hospital Parkway, Bedford, Tarrant County, Texas, 76022-5841, United States
BEDFORD, TX 760225913
Phone: (817) 848-2880
Fax: (817) 848-2890
Type: Mailing
PO BOX 746079
ATLANTA, GA 303746079
Phone: (817) 848-2880
Fax: (817) 848-2890
Type: Mailing
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: 2018-03-15
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 |
|---|---|---|---|---|
| I20180315000474 | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 142 | 61 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 83 | 50 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 58 | 34 | $0 |
Insurance plans in this area (ZIP 76022)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | WA | |
| Internal Medicine | FL | |
| Family Practice | MN | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | OH | |
| Clinical Social Worker | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | MD | |
| Clinical Social Worker | FL |
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