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Alfaye Jackson , PLPC

Counselor - Professional β€’ Rolla, MO

Active NPI 1770749905 Individual Practitioner Female Practitioner
Practice location in NPPES

104 Fox Creek Rd
Rolla, MO 654013620

Call 4176932770 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

104 Fox Creek Rd

Rolla, MO 654013620

Telephone 4176932770

NPI first issued

2008

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Alfaye Jackson has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Alfaye Jackson as eligible to order or refer Medicare Part B clinical laboratory and imaging services and durable medical equipment (DME) for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Rolla and Missouri

59 active clinicians are listed under Counselor - Professional with a practice address in Rolla, MO (5,803 in Missouri).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Rolla

5.1% of these 59 clinicians have the CMS telehealth indicator.

20.3% of these 59 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2022-11-21
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

License # reported to NPPES MO 2015044726
Counselor - Professional

NUCC Taxonomy Code: 101YP2500X

License # reported to NPPES MO 2008015070
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Missouri Board of Registration for the Healing Arts.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
490047336 (MO)

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

ORDER AND REFERRING ONLY - MENTAL HEALTH COUNSELOR

Medicare Enrollment ID

I20251029001591

Enrollment State Jurisdiction

MO

PECOS Control ID

6305335464

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Not Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

16 Historical Events
πŸ“
Updated Practice Location November 21, 2022

Registered at 104 FOX CREEK RD, ROLLA, MO 654013620 (Tel: 4176932770)

πŸ“
Updated Business Mailing Address November 21, 2022

Registered at 104 FOX CREEK RD, ROLLA, MO 654013620

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) November 21, 2022

Counselor (license number reported to NPPES: MO 2008015070)

πŸ“
Updated Practice Location July 16, 2021

Registered at 3100 S NATIONAL AVE STE 103, SPRINGFIELD, MO 658077347 (Tel: 4173226622)

πŸ“
Updated Business Mailing Address July 16, 2021

Registered at 3600 S NATIONAL AVE, SPRINGFIELD, MO 658077311 (Tel: 4173226622)

πŸ“
Updated Practice Location July 24, 2019

Registered at 1949 E CHERRY ST, SPRINGFIELD, MO 65802 (Tel: 4177610300)

πŸ“
Updated Business Mailing Address July 24, 2019

Registered at 3101C S KIMBROUGH AVE, SPRINGFIELD, MO 658075011 (Tel: 4178667773)

πŸ“
Updated Practice Location March 12, 2019

Registered at 1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804 (Tel: 4177615000)

πŸ“
Updated Business Mailing Address March 12, 2019

Registered at 1300 E BRADFORD PKWY, SPRINGFIELD, MO 658044264 (Tel: 4177615000)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 12, 2019

Counselor (license number reported to NPPES: MO 2015044726)

βœ…
NPI Profile Active August 07, 2008

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) August 07, 2008

Registered at 104 FOX CREEK RD, ROLLA, MO 654013620 (Tel: 5733084809)

πŸ“
Business Mailing Address (Initial Record) August 07, 2008

Registered at 104 FOX CREEK RD, ROLLA, MO 654013620 (Tel: 5733084809)

πŸ‘€
Provider Name / Credentials (Initial Record) August 07, 2008

Recorded as ALFAYE JACKSON, PLPC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 07, 2008

Counselor (license number reported to NPPES: MO 2008015070)

🟒
Initial NPI Registration & Enumeration August 07, 2008

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1770749905
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 07, 2008
Last Update: November 21, 2022
Sole Proprietor: Yes

Mailing Address

104 Fox Creek Rd

Rolla, MO 654013620

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.