JACOB JACKSON APRN CNP NPI 1134629405

NPI Information

  • NPI: 1134629405
  • Provider Name: JACOB JACKSON, APRN, CNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1800 W 1ST ST STE 105B
    ELK CITY, OK
    ZIP 73644
  • Phone: (580) 225-2518

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NPI Details

Jacob Jackson, APRN, CNP is a family nurse practitioner in Elk City, OK with 8 years of experience. Jacob Jackson, APRN, CNP NPI is 1134629405. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1800 W 1ST ST STE 105B
ELK CITY, OK
ZIP 73644-133
Phone: (580) 225-2518
Fax: (580) 225-3167

The NPI 1134629405 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.

  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
  • Hernia repair - groin (open) (HCPCS:NAN19)

The enumeration date for this NPI number is 2/13/2018 and was last updated on 3/26/2020.

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 PractitionerFamily113330OKLAHOMAYes
2163WM0705XRegistered NurseMedical-Surgical113330OKLAHOMANo

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: 3/30/2025

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