Mika Tralayne Jackson, APRN, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

20566 Issued in TN

Practice address

Mental Health Cooperative
Memphis, TN 38122-2127

Phone

(866) 816-0433

NPI assigned

Nov 17, 2015

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 TN, WA2 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

Univeristy of Texas Rio Grande Valley Med School, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

American Behavioral Health Systems, Inc.Group PAC ID 9335550052, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mika.jackson.1@24435.direct.athenahealth.com

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.

• American Behavioral Health Systems, Inc.

  • Substance Abuse Rehabilitation Facility
  • Spokane Valley, WA
  • NPI 1962991661
  Medicare reassignment Care Compare group NPD
• Mental Health Cooperative, Inc

  dba Mental Health Cooperative

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Nashville, TN
  • NPI 1083632897
  Medicare reassignment NPD
• Braxton Medical Clinic, LLC

  • Primary Care Clinic/Center
  • Murfreesboro, TN
  • NPI 1780281527
  NPD
• Just Journey Wellness Clinic LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Memphis, TN
  • NPI 1669159356
  NPD
• American Behavioral Healt Systems, Inc.

  dba Parkside

  • Community/Behavioral Health Agency
  • Wenatchee, WA
  • NPI 1437634888
  NPD
• American Behavioral Health Systems, Inc.

  • Substance Abuse Rehabilitation Facility
  • Chehalis, WA
  • NPI 1598123226
  NPD
• Axial Clinic TN PC

  dba Wayspring Clinic

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1184471872
  NPD (past)

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1184098956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 CUMBERLAND BND",
            "city": "NASHVILE",
            "state": "TN",
            "postal_code": "37228",
            "telephone_number": "615-726-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MENTAL HEALTH COOPERATIVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381222127",
            "telephone_number": "866-816-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MIKA",
        "middle_name": "TRALAYNE",
        "credential": "APRN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-17",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "20566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie D'Layne Jackson
• Macey Elizabeth Jackson, DDS
• Marine Jackson
• Mary Michael Jackson, DO
• Melody Jackson, D.C.
• Milissa Jackson, D.PH.
• Nevonda Venice Jackson, PHARM.D.
• Otis Jackson Jr.
• Pamela A Jackson
• Rasheedah Jackson

• Psychiatric/Mental Health Nurse Practitioner in Memphis, TN
• Providers in Memphis, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.