Wallace J Jackmon, PHD - Medicare Psychologist in Sioux Falls, SD

Wallace J Jackmon, PHD is a medicare enrolled "Psychologist - Clinical" provider in Sioux Falls, South Dakota. He graduated from medical school in 2007 and has 17 years of diverse experience with area of expertise as Clinical Psychologist. He is a member of the group practice Avera Mckennan and his current practice location is 4400 W 69th St, Ste 1500, Sioux Falls, South Dakota. You can reach out to his office (for appointments etc.) via phone at (605) 322-5700.

Wallace J Jackmon is licensed to practice in South Dakota (license number 477) 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 1427020957.

Contact Information

Wallace J Jackmon, PHD
4400 W 69th St, Ste 1500,
Sioux Falls, SD 57108-8170
(605) 322-5700
(605) 322-5704



Healthcare Provider's Profile

Full NameWallace J Jackmon
GenderMale
SpecialityClinical Psychologist
Experience17 Years
Location4400 W 69th St, Sioux Falls, South Dakota
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:
  • Wallace J Jackmon graduated from medical school in 2007
  NPI Data:
  • NPI Number: 1427020957
  • Provider Enumeration Date: 02/07/2006
  • Last Update Date: 10/11/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 6709896467
  • Enrollment ID: I20090424000148

Medical Identifiers

Medical identifiers for Wallace J Jackmon such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1427020957NPI-NPPES
12200MedicaidND
46022474352MedicaidNE
854000OtherSDARAZ/ AMERICA'S PPO
944611700MedicaidMN
0040537OtherSDBLUE CROSS
140M8JAOtherMNCC SYSTEMS/ BLUE PLUS
142415OtherMNUCARE
412991020844OtherSDPREFERRED ONE
6552790MedicaidSD
6570753MedicaidSD
800013808OtherSDRR MEDICARE
HP37115OtherSDHEALTHPARTNERS
15096OtherSDMIDLANDS CHOICE
20814OtherSDSANFORD HEALTH PLAN
3989442MedicaidIA
57108C003OtherSDWPS TRICARE
9205351OtherSDDAKOTACARE
040121002OtherMNPRIMEWEST

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical 477 (South Dakota)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Avera Mckennan Hospital & University Health CenterSioux falls, SDHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Avera Mckennan0345157103848

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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. Wallace J Jackmon allows following entities to bill medicare on his behalf.
Entity NameAvera Mckennan
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003389206
PECOS PAC ID: 0345157103
Enrollment ID: O20031110000117

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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. Wallace J Jackmon 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
Wallace J Jackmon, PHD
Po Box 86370,
Sioux Falls, SD 57118-6370

Ph: (605) 322-7510
Wallace J Jackmon, PHD
4400 W 69th St, Ste 1500,
Sioux Falls, SD 57108-8170

Ph: (605) 322-5700

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Psychologist in Sioux Falls, SD

Dr. Rachel Mcclure, PHD
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 2501 W 22nd St, Sioux Falls, SD 57105
Phone: 605-336-3230    
Dr. Thomas Charles Himler, PH.D.
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 1100 S Cliff Ave, Sioux Falls, SD 57105
Phone: 605-332-3706    
Joel Sonnichsen,
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 201 E 38th St, Sioux Falls, SD 57105
Phone: 605-367-7924    
Nancy Ann Johnson, PHD
Psychologist
Medicare: Accepting Medicare Assignments
Practice Location: 4400 W. 69th St., Ste. 1500, Sioux Falls, SD 57108
Phone: 605-322-5700    Fax: 605-322-5704
Ashton Moody,
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 201 E 38th St, Sioux Falls, SD 57105
Phone: 605-367-7924    
Dr. Jennifer Kae Helkenn, PH.D.
Psychologist
Medicare: Accepting Medicare Assignments
Practice Location: 2109 S Norton Ave, Sioux Falls, SD 57105
Phone: 605-334-2696    
Brenda Michelle Lindsay Nour, PH.D.
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 4400 W 69th St Ste 1500, Sioux Falls, SD 57108
Phone: 605-480-1482    

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