Yinka Shuntina Jackson, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN11003519 Issued in FL

Practice address

7369 Sheridan St Ste 203
Hollywood, FL 33024-2776

Phone

(954) 983-5330

Fax

(954) 983-5086

NPI assigned

Jul 29, 2019

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 FL, NC2 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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Chrysalis Center, Inc.Group PAC ID 8325186646, 36 clinicians

Alexander Pushka MD PAGroup PAC ID 1850554163, 5 clinicians

Advanced Psychiatric Services Professional AssociationGroup PAC ID 1850769878, 6 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.

• Advanced Psychiatric Services Professional Association

  • Psychiatry Physician
  • Hollywood, FL
  • NPI 1710603550

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Alexander Pushka MD PA

  • Child & Adolescent Psychiatry Physician
  • Hollywood, FL
  • NPI 1205101862

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Chrysalis Center, LLC

  • Community/Behavioral Health Agency
  • Fort Lauderdale, FL
  • NPI 1700961646
  Medicare reassignment Care Compare group NPD
• Alan a Jaffe PHD & Associates PA

  • Clinical Neuropsychologist
  • Coral Springs, FL
  • NPI 1326165655
  Medicare reassignment

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1104470038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7369 SHERIDAN ST STE 203",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330242776",
            "telephone_number": "954-983-5330",
            "fax_number": "954-983-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7369 SHERIDAN ST STE 203",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330242776",
            "telephone_number": "954-983-5330",
            "fax_number": "954-983-5086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6303 Blue Lagoon Dr Ste 400",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331266040",
            "country_code": "US",
            "telephone_number": "786-809-3606",
            "fax_number": "786-809-3616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8601 Six Forks Rd Ste 412",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276155276",
            "country_code": "US",
            "telephone_number": "984-283-0333",
            "fax_number": "984-283-0433",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8270 Woodland Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336142401",
            "country_code": "US",
            "telephone_number": "656-233-0010",
            "fax_number": "656-233-0011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2054 Vista Pkwy Ste 400",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334116742",
            "country_code": "US",
            "telephone_number": "561-216-0006",
            "fax_number": "954-350-0909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11555 Heron Bay Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Coral Springs",
            "state": "FL",
            "postal_code": "330763362",
            "country_code": "US",
            "telephone_number": "954-338-4303",
            "fax_number": "954-350-0909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2255 Glades Rd Ste 324A",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334318571",
            "country_code": "US",
            "telephone_number": "561-510-9190",
            "fax_number": "954-350-0909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3440 Toringdon Way Ste 205",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773191",
            "country_code": "US",
            "telephone_number": "980-375-6657",
            "fax_number": "980-375-6658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "YINKA",
        "middle_name": "SHUNTINA",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5019367",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11003519",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11003519",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Israel Salvador Jacas Carvajal
• Kenya A'Leesha Alyxx Jack
• Jade Indira Jackson
• Tamara M Jackson
• Tiffany Chelan Jackson, MSN, RN
• Binish Kinalath Jacob
• Riya Jacob
• Jacobo Elgozy M.D.P.a
• Charles Jacobs, M.D.
• Jeremy Allen Jacobs, DO

• Psychiatric/Mental Health Nurse Practitioner in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.