Megan Jackson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

198878 Issued in AK

Practice address

1650 Cowles St
Fairbanks, AK 99701-5907

Phone

(907) 458-5100

Fax

(907) 458-5151

NPI assigned

Feb 15, 2015

Last updated

Mar 20, 2023By the provider in NPPES

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IN, AK2 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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tanana Valley Clinic LLCGroup PAC ID 5698056901, 142 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairbanks Memorial Hospital Hospital, Fairbanks, AK, CCN 020012

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tanana Valley Clinic LLC

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1922559558
  Medicare reassignment Care Compare group NPD
• Community Physicians of Indiana Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1619105244
  Medicare reassignment NPD
• Tanana Valley Clinic LLC

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1073081485
  NPD
• Community Physicians of Indiana Inc

  dba Community Physician Network

  • Endocrinology, Diabetes & Metabolism Physician
  • Carmel, IN
  • NPI 1992396337
  NPD

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

• Fairbanks Memorial Hospital, LLC

  • General Acute Care Hospital
  • Fairbanks, AK
  • NPI 1720537178
  Care Compare affiliation

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

{
    "created_epoch": "1423958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1205227097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 N EATON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015907",
            "telephone_number": "907-458-5100",
            "fax_number": "907-458-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MEGAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-15",
        "last_updated": "2023-03-20",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "2819322A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "198878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "198878",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201282850",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN LICENSE",
            "identifier": "71005406A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P01512420",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald Ives, M.D.
• Precious Eyewumi Izeagi, MSN, APRN, PMHNP-BC
• Jace LLC
• Amani Ayisha Jackson
• Cassie Thacker Jackson, MASTER OF EDUCATION
• Nakea Jackson, PTA
• Rickale K Jackson
• Tanya L Jackson
• Vanessa Rachel Jackson, CDM
• Elizabeth D Jacobs, MA CCCSLP

• Family Nurse Practitioner in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Family Nurse Practitioner in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.