Chelsea Nicole Jackson, FNP-C
Individual provider Active NPI Nurse Practitioner · Greensboro, NC
NPI 1235622929 · NPPES record last updated Feb 11, 2025
Key facts
- NPI
- 1235622929
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 5010583 (NC)
- Practice address
- 3922 W Market St
Greensboro, NC 27407-1304 - Phone
- (336) 252-3993
- Fax
- (855) 308-2340
- NPI assigned
- Jun 7, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lamond Family Medicine PLLC
Practice addresses (Care Compare)
3922 W Market St
Greensboro, NC 27407-1304
Phone (336) 252-3993
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180910001512 | NC | Practitioner - Nurse Practitioner | 6406106681 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lamond Family Medicine, PLLC | Current |
Accepting new patients | |
| Cityblock Medical Practice, P.a. | Past |
Accepting new patients |
Locations
3922 W Market St
Greensboro, NC 27407
Phone (336) 252-3993
317 N King St
#A
Hendersonvlle, NC 28792
Phone (828) 693-3344
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5010583 | NC | Yes |
Addresses
Primary practice location
3922 W Market St
Greensboro, NC 27407-1304
Mailing address
PO Box 360
Sylva, NC 28779-0360
Phone (888) 339-6065
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19YAM | Other | NC | BCBS NC |
| 3164062 | Other | NC | CIGNA |
| NN3436B | Other | NC | MEDICARE |
| Q00928703 | Other | NC | RAILROAD MEDICARE |
| LX493E-AC | Other | NC | DEVOTED HEALTH |
| 1235622929 | Medicaid | NC |
Other providers in Greensboro, NC
- Harold N Jacklin
- Ariel Jackson
- Benjamin Jackson
- Carley Jackson
- Carswell Hoots Jackson
- Christine L Jackson
- Delphia Dent Jackson
- Desmaine Jackson
- Dominique Jackson
- Freeman R Jackson Jr.
All providers in Greensboro, NC · Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.