Jackyline N Kikoyo, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN2319823 Issued in MA

Practice address

58 Main St
Sturbridge, MA 01566-1507

Phone

(774) 240-6869

NPI assigned

Nov 18, 2024

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 VA

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Norfolk Psychiactric Associates PCGroup PAC ID 7618907551, 13 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.

• Norfolk Psychiactric Associates PC

  • Specialist
  • Norfolk, VA
  • NPI 1922198100
  Medicare reassignment Care Compare group NPD
• Legacy Care Aco LLC

  • Family Medicine Physician
  • Virginia BCH, VA
  • NPI 1538844857
  NPD
• Legacy Care LLC

  • Family Medicine Physician
  • Virginia Beach, VA
  • NPI 1902149776
  NPD

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1144045899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 MAIN ST",
            "city": "STURBRIDGE",
            "state": "MA",
            "postal_code": "015661507",
            "telephone_number": "774-240-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 MAIN ST",
            "city": "STURBRIDGE",
            "state": "MA",
            "postal_code": "015661507",
            "telephone_number": "774-240-6869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2901 S Lynnhaven Rd Ste 450",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234528524",
            "country_code": "US",
            "telephone_number": "502-529-2580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIKOYO",
        "first_name": "JACKYLINE",
        "middle_name": "N",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-18",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2319823",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "24193111",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry A Johnson, DDS
• Kristina Joy, PT, DPT
• Dnyanesh Pranay Kanake, OT/L
• Stephanie Elizabeth Keaney, MD
• James L Kiely, MT
• Debra Kizilcan
• Jolynn Klier, PH.D
• Kara Emily Krantz
• Randi Adele Krogstad, MSW
• Mikayla Kurtz, M.S., BCBA

• Psychiatric/Mental Health Nurse Practitioner in Sturbridge, MA
• Providers in Sturbridge, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.