Julia Jackson, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704328543 Issued in MI

Practice address

4640 Mill Pond Dr
Troy, MI 48085-3782

Phone

(615) 415-7522

NPI assigned

Oct 29, 2021

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 MI

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

Merit-based Incentive Payment System (MIPS)

Final score

57.96 of 100Reported as group

Quality

21.71

Promoting interoperability

12

Improvement activities

40

Cost

78.16

Medicare enrollment (NPD)

Enrolled

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.

• Behavioral Care Solutions for Adults and Seniors, Inc.

  • Psychiatry Physician
  • Novi, MI
  • NPI 1154727147
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  MI, Nurse Practitioner

  Medicare reassignment NPD

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

{
    "created_epoch": "1635465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1215691753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 MILL POND DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480853782",
            "telephone_number": "615-415-7522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 MILL POND DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480853782",
            "telephone_number": "615-415-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JULIA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-29",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704328543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacastillano PLLC
• Mercedese Jack
• Denise Jackson
• Erica L Jackson
• Fredericka Arlene Jackson, PH.D. CAC II
• Kenya Jackson
• Marcus Dangelo Jackson
• Natalie Jeanee Jackson
• Nicole Jackson
• Ashley Mariam Jacob, PSYD

• Nurse Practitioner in Troy, MI
• Providers in Troy, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; 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.