Active NPI 1699001289 Individual Practitioner Female Practitioner

Kimberly Ann Jackson , NP

Nurse Practitioner • Mount Vernon, IN

Professional Overview & Biography Verified Profile Summary

Kimberly Jackson, NP is a registered healthcare professional specializing in Nurse Practitioner in Mount Vernon, IN. Practice services are available at 813 E 4TH ST under active NPI credentials.

Frequently performed procedures and clinical services include established patient outpatient office visit, detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19), influenza virus types a and b, and respiratory syncytial virus, automated urinalysis test. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

813 E 4th St
Ste A

Mount Vernon, IN 476202012

Telephone 8128382139

Fax 8128389214

Associated Practice Facility / Clinic

🏢 Deaconess Clinic, Inc Facility NPI 1376267799

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Mount Vernon, IN

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 7.7 Yrs

State Avg: 10.9 Yrs

Regional Practice Density

4 Specialists

Practicing in Mount Vernon, IN (2620 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

64.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	86	84	$170.00	$71.03
87637 Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19), influenza virus types a and b, and respiratory syncytial virus	26	26	$395.00	$134.83
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	23	22	$248.00	$97.88
81003 Automated urinalysis test	16	16	$18.00	$2.20
87651 Detection test for Strep (Streptococcus, group A)	15	15	$140.00	$34.39

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	122	106	$170.00	$71.37
87637 Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19), influenza virus types a and b, and respiratory syncytial virus	31	30	$395.00	$139.78
81003 Automated urinalysis test	22	19	$18.00	$2.20
87651 Detection test for Strep (Streptococcus, group A)	22	21	$140.00	$34.39
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	18	17	$248.00	$102.81

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	124	111	$170.00	$72.52
87637 Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19), influenza virus types a and b, and respiratory syncytial virus	54	51	$402.67	$140.75
0054A Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 30 mcg/0.3ml dosage, tris-sucrose formulation; booster dose	34	34	$45.00	$36.46
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	17	17	$248.00	$103.33
G0008 Administration of influenza virus vaccine	17	17	$40.00	$27.27
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	15	15	$135.00	$70.25
87651 Detection test for Strep (Streptococcus, group A)	11	11	$140.00	$31.66

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	97	88	$165.15	$73.30
0003A Adm sarscov2 30mcg/0.3ml 3rd	63	63	$45.00	$37.21
0004A Fee covid-19 vac 1 res	54	54	$45.00	$37.21
G0008 Administration of influenza virus vaccine	24	24	$39.00	$15.83
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	23	23	$110.00	$66.43
81003 Automated urinalysis test	18	16	$18.00	$2.25
0001A Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 30 mcg/0.3ml dosage, diluent reconstituted; first dose	16	16	$45.00	$37.21
0002A Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 30 mcg/0.3ml dosage, diluent reconstituted; second dose	16	16	$45.00	$37.21
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	15	15	$234.00	$104.25
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$238.00	$89.83

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	93	84	$123.00	$59.14
87804 Detection test by immunoassay with direct visual observation for influenza virus	28	14	$48.00	$16.27
81003 Automated urinalysis test	19	17	$18.00	$2.23
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	13	12	$174.31	$87.49
G0008 Administration of influenza virus vaccine	13	13	$38.69	$15.85
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$183.00	$86.24

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	292	168	$123.00	$59.31
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	55	47	$174.00	$85.84
87804 Detection test by immunoassay with direct visual observation for influenza virus	44	25	$48.00	$16.22
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	41	41	$221.00	$92.52
G0008 Administration of influenza virus vaccine	23	23	$38.00	$15.55
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	22	20	$46.00	$13.29
81003 Automated urinalysis test	19	18	$18.00	$2.44
G0009 Administration of pneumococcal vaccine	16	16	$38.00	$15.55
90653 Vaccine for influenza for injection into muscle	15	15	$65.00	$58.34
90670 Pneumococcal vaccine for injection into muscle	11	11	$335.00	$204.65

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	337	150	$123.00	$58.08
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	95	54	$174.00	$86.37
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	80	80	$221.00	$93.25
90653 Vaccine for influenza for injection into muscle	78	78	$62.69	$53.52
G0008 Administration of influenza virus vaccine	78	78	$38.00	$19.10
G0009 Administration of pneumococcal vaccine	53	53	$38.00	$19.10
81002 Urinalysis, manual test	30	25	$18.00	$3.41
90670 Pneumococcal vaccine for injection into muscle	28	28	$317.82	$198.39
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	26	26	$146.00	$105.59
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	25	19	$46.00	$16.34
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	13	13	$363.00	$137.52

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	382	157	$123.00	$57.85
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	83	49	$174.00	$83.67
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	67	67	$221.00	$92.54
G0008 Administration of influenza virus vaccine	41	40	$38.00	$23.63
81002 Urinalysis, manual test	34	27	$18.00	$3.43
90662 Influenza vaccine split virus, preservative free	33	33	$72.00	$48.05
G0009 Administration of pneumococcal vaccine	28	28	$38.00	$23.63
90670 Pneumococcal vaccine for injection into muscle	21	21	$298.00	$187.71
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	20	11	$46.00	$20.24

Medical Specialties & State Licenses

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License IN 71003090A

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Nurse Practitioner - Family

NUCC Taxonomy Code: 363LF0000X

State License IN 71003090A

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

200976080 (IN)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners

Keely Brown , NP

Nurse Practitioner

NPI 1407475627

Nurse Practitioner

Leigh Fromm , PMHNP, FNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1437632981

Psychiatric-Mental Health Nurse Practitioner, Family Nurse Practitioner

Joanna Osterman

Nurse Practitioner

NPI 1518649391

Dr. William Sutton , MD

Family Medicine

NPI 1902879109

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active January 03, 2013

NPI status registered as active in NPPES database

📍

Updated Practice Location January 03, 2013

Registered at 813 E 4TH ST, STE A, MOUNT VERNON, IN 476202012 (Tel: 8128382139)

📍

Updated Business Mailing Address January 03, 2013

Registered at PO BOX 1510, EVANSVILLE, IN 477061510 (Tel: 8128382139)

👤

Provider Name / Credentials Updated January 03, 2013

Recorded as KIMBERLY JACKSON, N.P.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 03, 2013

Nurse Practitioner (License #71003090A in IN)

🟢

Initial NPI Registration & Enumeration November 02, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1699001289

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: November 02, 2009

Last Update: January 03, 2013

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 1510

Evansville, IN 477061510

Phone: 8128382139

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.