Cory David Jackson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

96293 Issued in WV

Practice address

1340 Hal Greer Blvd
Huntington, WV 25701-3804

Phone

(304) 399-6727

Fax

(304) 399-6726

NPI assigned

Jun 10, 2020

Last updated

May 21, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC, WV, OH3 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 3

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Point Pleasant Physician Billing ServicesGroup PAC ID 3375538184, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rivers Health Hospital, Point Pleasant, WV, CCN 510012

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cory.jackson@direct.chhi.org

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.

• Point Pleasant Physician Billing Services

  • Multi-Specialty Clinic/Center
  • PT Pleasant, WV
  • NPI 1396798898
  Medicare reassignment Care Compare group NPD
• Allied West Virginia Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Huntington, WV
  • NPI 1487109104
  Medicare reassignment NPD
• Racine Observation Medical Group, PLLC

  • Emergency Medicine Physician
  • Huntington, WV
  • NPI 1588196851
  Medicare reassignment NPD
• St Mary's Hospitalist Services, LLC

  • Internal Medicine Physician
  • Huntington, WV
  • NPI 1942432687

  Family

  Medicare reassignment NPD
• THS Physician Partners Inc

  • Internal Medicine Physician
  • South Charleston, WV
  • NPI 1871866806

  Family

  Medicare reassignment NPD
• DLP Rutherford Physician Practices LLC

  • Family Medicine Physician
  • Forest City, NC
  • NPI 1962821322
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Ohio-Columbus II Professional Corp

  • Internal Medicine Physician
  • Chillicothe, OH
  • NPI 1861038069
  Medicare reassignment
• DLP Rutherford Physician Practices LLC

  dba Rutherford Family Care

  • Rural Health Clinic/Center
  • Rutherfordton, NC
  • NPI 1720849391
  NPD
• DLP Rutherford Physician Practices LLC

  dba Rutherford Orthopaedics

  • Orthopaedic Surgery Physician
  • Rutherfordton, NC
  • NPI 1275943698
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pleasant Valley Hospital, Inc.

  dba Rivers Health

  • General Acute Care Hospital
  • PT Pleasant, WV
  • NPI 1598975120
  Care Compare affiliation

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1194340687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5507 SHAWNEE DR",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257053305",
            "telephone_number": "304-690-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 HAL GREER BLVD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013804",
            "telephone_number": "304-399-6727",
            "fax_number": "304-399-6726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3120 US Route 60",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257052739",
            "country_code": "US",
            "telephone_number": "304-522-3627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CORY",
        "middle_name": "DAVID",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-10",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "96293",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "WV",
            "license": "96293",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Cory.Jackson@direct.chhi.org",
            "affiliation": "N",
            "address_1": "1340 Hal Greer Blvd",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257013804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alzeriya Jackson
• Bruce Jackson, RN, FA
• Camela L. Jackson, MSW
• Chantel Jackson
• Christian Jackson
• Cynthia Jackson
• Hannah J Jackson
• Hope A Jackson
• Jacqueline A Jackson, CFNP
• Jamie Lynn Jackson

• Family Nurse Practitioner in Huntington, WV
• Providers in Huntington, WV by specialty
• Family Nurse Practitioner in West Virginia

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