Stacey Jackson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP134528 Issued in TX

Practice address

1604 Hospital Pkwy Ste 100
Bedford, TX 76022-5913

Phone

(817) 848-2880

Fax

(817) 848-2890

NPI assigned

Aug 16, 2017

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 TX

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oak Street Health of Texas PLLCGroup PAC ID 2163843038, 103 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Oak Street Health of Texas, PLLC

  • Primary Care Clinic/Center
  • Fort Worth, TX
  • NPI 1497387419

  Family

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1134645674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746079",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746079",
            "telephone_number": "817-848-2880",
            "fax_number": "817-848-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 HOSPITAL PKWY STE 100",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760225913",
            "telephone_number": "817-848-2880",
            "fax_number": "817-848-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "STACEY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-16",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP134528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Jones Hearing Centers, Inc.
• Mahalia L Jackson-Butler, DNP, APRN
• Antonious Dewayne Jackson, D.C., F.N.P-C
• Ryan C Jackson, MD
• Sharon L Jackson, MD
• Tinu Elsa Jacob, RPH
• Janus Long Jacobs, FNP
• Banny Jasmine Jaen
• Enilse Jaen
• Desoree James

• Family Nurse Practitioner in Bedford, TX
• Providers in Bedford, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.