Markquetta Renee Jackson, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3008203 Issued in KY

Practice address

406 Blankenbaker Pkwy Ste C1
Douglass Hills, KY 40243-1881

Phone

(502) 654-9575

NPI assigned

Jul 17, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KY, NV, WY, GA, IN5 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 5

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Behavioral Health Solutions LLCGroup PAC ID 4385998954, 60 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.16 of 100Reported as group

Quality

80.29

Promoting interoperability

95

Improvement activities

40

Cost

61.08

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: markquetta.jackson.1@24259.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Careangel Mental Health and Wellness

  • Psychiatric/Mental Health Nurse Practitioner
  • Douglass Hills, KY
  • NPI 1407626518

  IN, KY, Psychiatric/Mental Health

  Medicare reassignment NPD Authorized official
• Behavioral Health Solutions LLC

  • Community/Behavioral Health Agency
  • Henderson, NV
  • NPI 1548765258

  NV

  Medicare reassignment Care Compare group NPD
• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  KY

  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  GA, NV

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  WY

  Medicare reassignment NPD
• Next Level Psychiatry Arizona PLLC

  • Psychiatry Physician
  • Tucson, AZ
  • NPI 1932703626
  NPD
• A Newco LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Louisville, KY
  • NPI 1285103937

  Family

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1013358183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 PASEO VERDE PKWY STE 190",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522703",
            "telephone_number": "702-589-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 BLANKENBAKER PKWY STE C1",
            "city": "DOUGLASS HILLS",
            "state": "KY",
            "postal_code": "402431881",
            "telephone_number": "502-654-9575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Paseo Verde Pkwy Ste 190",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890522703",
            "country_code": "US",
            "telephone_number": "702-589-4871",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1939 Goldsmith Ln Ste 100",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402183090",
            "country_code": "US",
            "telephone_number": "502-873-7517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MARKQUETTA",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "842906",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3008203",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3008203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Careangel Mental Health and Wellness

• All providers in Douglass Hills, KY
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.