Michelle Jackson, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

21621 Issued in CA

Practice address

5434 Olive St Unit a
San Diego, CA 92105-5054

Phone

(619) 840-9440

NPI assigned

Sep 17, 2010

Last updated

Apr 7, 2026By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Daniel Funsch Jr MD Professional CorporationGroup PAC ID 3870028046, 13 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.67 of 100Reported as group

Quality

81.04

Promoting interoperability

99

Improvement activities

40

Cost

82.04

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.

• Daniel Funsch Jr, M.D., Professional Corporation

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1376389163

  CA

  Medicare reassignment Care Compare group NPD
• Memory Check Psychological Services, a Professional Corporation

  • Clinical Psychologist
  • Carlsbad, CA
  • NPI 1912184219

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Sharp Rees-Stealy Medical Group, Inc

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1285616177

  Nurse Practitioner

  Medicare reassignment NPD
• Myezmed

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1982441341
  Medicare reassignment
• Root Healing SD

  • Psychiatric/Mental Health Nurse Practitioner
  • San Diego, CA
  • NPI 1396650248
  NPD (past) Authorized official
• Sharp Rees-Stealy Medical Group, Inc

  • Optometrist
  • San Diego, CA
  • NPI 1063172351
  NPD

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

{
    "created_epoch": "1284681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1093023509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5434 OLIVE ST UNIT A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921055054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5434 OLIVE ST UNIT A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921055054",
            "telephone_number": "619-840-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-17",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "21621",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "21621",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keturah Renee Jackson
• La Tasha Jackson
• London Jackson
• Madelyn Joy Jackson
• Megan Ann Jackson
• Natasha Jackson, LMFT
• Noha Jackson, PHARM. D.
• Paris Jackson
• Robert Jackson Jr., NONE
• Sainyah A Jackson

• Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; 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.