Jacqueline Marie Jackson, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9363278 Issued in FL

Practice address

2114 Creighton Road
Pensacola, FL 32504

Phone

(850) 696-4000

NPI assigned

Mar 21, 2018

Last updated

Jan 27, 2025By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trinova Healthcare LLCGroup PAC ID 1658809074, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Hospital Hospital, Pensacola, FL, CCN 100093
• Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025
• Gulf Breeze Hospital Hospital, Gulf Breeze, FL, CCN 100266

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Trinova Healthcare LLC

  dba Trinova Medical

  • Internal Medicine Physician
  • Pensacola, FL
  • NPI 1912733841
  Medicare reassignment Care Compare group NPD
• Alc Consulting LLC

  dba Alicia Chen MD

  • Internal Medicine Physician
  • Pensacola, FL
  • NPI 1174880660
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Health Care, Inc

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1700979465
  Care Compare affiliation
• Baptist Health Care, Inc.

  dba Gulf Breeze Hospital

  • General Acute Care Hospital
  • Gulf Breeze, FL
  • NPI 1972664530
  Care Compare affiliation
• Sacred Heart Health System, Inc.

  dba Ascension Sacred Heart Pensacola

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1922032424
  Care Compare affiliation

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1083118350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 CREIGHTON RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325047218",
            "telephone_number": "850-848-9500",
            "fax_number": "850-901-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 CREIGHTON ROAD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32504",
            "telephone_number": "850-696-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-21",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9363278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP",
            "identifier": "ARNP9363278",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley Daniel Jackson, CRNA
• Charlotte Jackson
• Daniel Jackson
• Debra Ann Jackson, DC
• Erin Audrey Marie Jackson, M.D
• Jamie B Jackson, APRN
• Jamie Crystal Jackson, M.D.
• Jennifer Reiss Jackson, OTR/L
• Karen Jackson, CRNP
• Kiara Lashantae Jackson, MSW

• Family Nurse Practitioner in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.