Pamela Dean Reaves Jackson, CRNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

1-054775 Issued in AL

Practice address

1131 Leighton Ave
Anniston, AL 36207-4610

Phone

(256) 237-0025

NPI assigned

Sep 9, 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

Enrolled in AL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Crosen Medical, LLCGroup PAC ID 5395905624, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pam.jackson.1@31010.direct.athenahealth.com

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.

• Crosen Medical, LLC

  • Adult Health Nurse Practitioner
  • Oxford, AL
  • NPI 1528330842
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1473379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1386191112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 LEIGHTON AVE",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362074610",
            "telephone_number": "256-237-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 LEIGHTON AVE",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362074610",
            "telephone_number": "256-237-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "PAMELA",
        "middle_name": "DEAN REAVES",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-09",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-054775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dylan Isenhower
• Mohammad Fateh Ismail, MD
• Sapphire A Israel
• J. Shan Young, MD LLC
• Betty Hill Jackson, M.S.,CCC-A
• Stacy Harkins Jackson, LICSW
• Wayne Paul Jackson, LCSW,PIP,CEAP
• James L Finley Dentistry
• Jason W. Cook, OD, LLC
• Mohamed Jasser, MD

• Acute Care Nurse Practitioner in Anniston, AL
• Providers in Anniston, AL by specialty
• Acute Care Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2016; 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.