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KIMBERLY ANN JACKSON N.P. NPI 1699001289


NPI Information

NPI: 1699001289
Provider Name: KIMBERLY ANN JACKSON, N.P.
Classification: Nurse Practitioner - 363L00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
813 E 4TH ST
STE A
MOUNT VERNON, IN
ZIP 47620
Phone: (812) 838-2139
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Kimberly Ann Jackson, N.P. is a nurse practitioner in Mount Vernon, IN with 15 years of experience. The provider is (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. Kimberly Ann Jackson, N.P. NPI is 1699001289. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

813 E 4TH ST
STE A
MOUNT VERNON, IN
ZIP 47620-012
Phone: (812) 838-2139
Fax: (812) 838-9214

The NPI 1699001289 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Automated urinalysis test (HCPCS:81003)
  • Administration of influenza virus vaccine (HCPCS:G0008)

The enumeration date for this NPI number is 11/2/2009 and was last updated on 1/3/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily71003090AINDIANANo
2363L00000XNurse Practitioner71003090AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200976080MEDICAIDINDIANA
2257900B7MEDICARE PININDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.