Allie Jackson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F06211962 Issued in MO

Practice address

1435 E Bradford Pkwy Ste 105
Springfield, MO 65804-6512

Phone

(417) 881-4994

NPI assigned

Jul 13, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

NP Health of Mo LLCGroup PAC ID 4183047053, 17 clinicians

Practice addresses (Care Compare)

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.

• NP Health of Mo LLC

  • Physical Medicine & Rehabilitation Physician
  • Morton Grove, IL
  • NPI 1477170959

  MO

  Medicare reassignment Care Compare group NPD
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1053983734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 E BRADFORD PKWY STE 105",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046512",
            "telephone_number": "417-881-4994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 E BRADFORD PKWY STE 105",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046512",
            "telephone_number": "417-881-4994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ALLIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "F06211962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Itooth Family Dentistry, LLC
• Sara Nicole Iverson, MA LMHC LPC
• J&J Senior Care of the Ozarks
• Peter E Jaberg, PH.D.
• Keitha Ann Jacellari, APRN, FNP-BC
• Courtney Jackson, LMT
• Delilah Yvette Jackson
• Michael Wayne Jackson, D.C.
• Rachael M Jackson, LMSW
• Sarah Beth Jackson, DDS

• Family Nurse Practitioner in Springfield, MO
• Providers in Springfield, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; 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.