Vicki Jackson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

4136 Bartlett St
Homer, AK 99603-7001

Phone

(907) 235-6127

NPI assigned

Mar 22, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Merit-based Incentive Payment System (MIPS)

Final score

70.59 of 100Reported as group

Quality

83.37

Promoting interoperability

100

Improvement activities

40

Cost

16.65

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• South Peninsula Hospital, Inc

  • Home Health Agency
  • Homer, AK
  • NPI 1164400750
  NPD
• South Peninsula Hospital, Inc.

  • Critical Access Hospital
  • Homer, AK
  • NPI 1679566269
  NPD
• Walla Walla Community Hospice

  • Community Based Hospice Care Agency
  • Walla Walla, WA
  • NPI 1497759203
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1083076772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 SMOKY BAY WAY # 140",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037653",
            "telephone_number": "509-496-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4136 BARTLETT ST",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037001",
            "telephone_number": "907-235-6127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "VICKI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Lynn Huyck, LMT
• Adam Hykes
• Independent Living Center, Inc
• Ian Inglis
• Inner Nature Chiropractic Inc
• James Bourne DDS PC
• Kristin Nicole James, DPT
• Elizabeth Jansen, LMT
• Haley Lorraine Jenkins, MS, CCC-SLP
• Kirstin Jensen

• Mental Health Counselor in Homer, AK
• Providers in Homer, AK by specialty
• Mental Health Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.