T Jackson, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5020358 Issued in NC

Practice address

713 Milton Bluff Lane
Holly Springs, NC 27540-4503

Phone

(984) 332-7015

NPI assigned

Dec 20, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Tracey Soper Former name

Medicare fee-for-service enrollment

Enrolled in CA, FL2 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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Adventist Health System Sunbelt, Inc.

  dba AdventHealth Centra Care

  • Urgent Care Clinic/Center
  • Maitland, FL
  • NPI 1073565610

  Family

  Medicare reassignment NPD
• Dispatchhealth-Florida Inc.

  • Emergency Medicine Physician
  • Tampa, FL
  • NPI 1407472723
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of California, Inc

  • Internal Medicine Physician
  • Apple Valley, CA
  • NPI 1184663965
  Medicare reassignment NPD
• Wound Technology Network Inc

  • Infectious Disease Physician
  • Orlando, FL
  • NPI 1962601393
  Medicare reassignment NPD
• Adventist Health System /Sunbelt, Inc.

  dba AdventHealth Centra Care Winter Haven

  • Urgent Care Clinic/Center
  • Winter Haven, FL
  • NPI 1013563816

  Family

  NPD
• Adventist Health System/ Sunbelt, Inc.

  dba AdventHealth Centra Care - Southern Trace

  • Urgent Care Clinic/Center
  • The Villages, FL
  • NPI 1396605440

  Family

  NPD
• Dispatchhealth-Florida Inc.

  • Emergency Medicine Physician
  • Doral, FL
  • NPI 1154097491
  NPD (past)
• WT Health of Florida LLC

  • Infectious Disease Physician
  • Orlando, FL
  • NPI 1982434106
  NPD (past)

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

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1033681655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 MILTON BLUFF LANE",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275404503",
            "telephone_number": "984-332-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 MILTON BLUFF LANE",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275404503",
            "telephone_number": "984-332-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "T",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-20",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5020358",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5020358",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "SOPER",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Manal Ibrahim, PHARMD
• Julia Eden Dietsche Im
• Innovative OT NC LLC
• Integrity Clinical Labs
• Kaori Watanabe Isaacson
• Sara K Jadi
• Andrew Robert James, DO
• Michelle Lee Janyska, RN,BSN,IBCLC
• Ashley Jarvis, RDN
• Sriraksha Jayananda, M.D.

• Family Nurse Practitioner in Holly Springs, NC
• Providers in Holly Springs, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.