JACQUELYNN DORMAN (FNP) – Family Nurse Practitioner, NPI 1962068981
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 JACQUELYNN DORMAN (FNP)
710, East 6th Street, Owen, Odessa, Ector County, Texas, 79761, United States
ODESSA, TX 797614655
Phone: (432) 582-2882
Type: Location
418, O'Rourke Street, Legends Park, Midland, Midland County, Texas, 79706, United States
MIDLAND, TX 79706
Phone: (432) 978-3022
Type: Mailing
4060 MEDICAL PARK DR
ODESSA, TX 797652233
Phone: (432) 582-2882
Fax: (432) 582-2884
Type: Location
6509 MOSSWOOD DR
MIDLAND, TX 797075075
Phone: (432) 978-3022
Fax: (432) 614-0876
Type: Mailing
1330 E 8TH ST STE 414
ODESSA, TX 797614733
Phone: (432) 614-2176
Fax: (432) 614-0876
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 54 Open Payments records for all available years, with a total value of $1,595.
Total Amount is formed as General ($1,595) + Research ($0) + Ownership ($0) = $1,595.
Last reported payment date: 2024-11-22 • Largest payer in this snapshot: ABBVIE INC. ($458).
Total Amount
$1,595
General + Research + Ownership
Payments
54
Total payment records
General Amount
$1,595
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $458 |
| AstraZeneca Pharmaceuticals LP | $387 |
| Lilly USA, LLC | $260 |
| Dexcom, Inc. | $116 |
| Novo Nordisk Inc | $116 |
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: 2019-07-11
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 |
|---|---|---|---|---|
| I20190711000418 | 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 |
|---|---|---|---|---|
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 58 | 26 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 36 | 31 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 30 | 26 | $0 |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | 29 | 26 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 29 | 21 | $0 |
Insurance plans in this area (ZIP 79761)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TX |
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