Clark Jackson, - Medicare Certified Registered Nurse Anesthetist (crna) in Lincoln, NE

Clark Jackson, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Lincoln, Nebraska. He graduated from nursing school in 2016 and has 8 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Northstar Anesthesia Of Nebraska Llc, The Urology Center, Pc, Mid Plains Anesthesia, Llc and his current practice location is 2500 S 60th St Apt 21, Lincoln, Nebraska. You can reach out to his office (for appointments etc.) via phone at (402) 613-2633.

Clark Jackson is licensed to practice in Nebraska (license number 70693) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1053768945.

Contact Information

Clark Jackson,
2500 S 60th St Apt 21,
Lincoln, NE 68506-3579
(402) 613-2633
Not Available



Provider's Profile

Full NameClark Jackson
GenderMale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience8 Years
Location2500 S 60th St Apt 21, Lincoln, Nebraska
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Clark Jackson graduated from nursing school in 2016
  NPI Data:
  • NPI Number: 1053768945
  • Provider Enumeration Date: 05/20/2016
  • Last Update Date: 05/20/2016
  Medicare PECOS Information:
  • PECOS PAC ID: 0345532057
  • Enrollment ID: I20160715000967

Medical Identifiers

Medical identifiers for Clark Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053768945NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered 70693 (Nebraska)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Northstar Anesthesia Of Nebraska Llc226485713523
The Urology Center, Pc296139683318
Mid Plains Anesthesia, Llc68002142973

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Clark Jackson allows following entities to bill medicare on his behalf.
Entity NameMemorial Community Hospital Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1265408819
PECOS PAC ID: 0749190775
Enrollment ID: O20040202001065

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Entity NameThe Urology Center, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114919875
PECOS PAC ID: 2961396833
Enrollment ID: O20040614001603

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Entity NameSt Marys Community Hospital
Entity TypePart A Provider - Critical Access Hospital
Entity IdentifiersNPI Number: 1528016995
PECOS PAC ID: 7113831926
Enrollment ID: O20071128000886

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Entity NameMetro Omaha Anesthesia Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1558884072
PECOS PAC ID: 1456626050
Enrollment ID: O20171009000112

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Entity NameChi Health Clinic Physician Enterprise-anesthesia Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1356858419
PECOS PAC ID: 2264794569
Enrollment ID: O20180404000022

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Entity NameOrthoanesthesia Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1184265274
PECOS PAC ID: 2860826443
Enrollment ID: O20200107003507

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Entity NameNorthstar Anesthesia Of Nebraska Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1578187670
PECOS PAC ID: 2264857135
Enrollment ID: O20200810001420

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Entity NameMid Plains Anesthesia, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1710500541
PECOS PAC ID: 6800214297
Enrollment ID: O20200917000179

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Clark Jackson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Clark Jackson,
2500 S 60th St Apt 21,
Lincoln, NE 68506-3579

Ph: (402) 613-2633
Clark Jackson,
2500 S 60th St Apt 21,
Lincoln, NE 68506-3579

Ph: (402) 613-2633

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Nurse Anesthetist, Certified Registered Nurses in Lincoln, NE

Matthew C. Oliver, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 6911 Van Dorn St Ste 2, Lincoln, NE 68506
Phone: 402-489-4186    Fax: 402-489-5279
Eric Johnson, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 2900 S 70th Street, Suite # 450, Lincoln, NE 68506
Phone: 402-489-4186    Fax: 402-489-5279
Hillary Marie Bonin, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 575 S 70th St Ste 305, Lincoln, NE 68510
Phone: 402-434-5600    Fax: 402-434-5601
Priscilla Boyer, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 575 S 70th St Ste 305, Lincoln, NE 68510
Phone: 402-434-5600    Fax: 402-434-5601
Carl C Blackwood, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 5701 Lillibridge St Apt 10, Lincoln, NE 68506
Phone: 607-349-9774    
Bridget L Hannon, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 2900 S 70th St Ste 250, Lincoln, NE 68506
Phone: 402-489-4186    Fax: 402-489-5279

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