Christine Denise Jackson, APRN,FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-130303 Issued in AL

Practice address

324 Courthouse SQ
Bay Minette, AL 36507-4809

Phone

(251) 580-2555

NPI assigned

Feb 25, 2009

Last updated

Sep 3, 2019By 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 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AL, FL2 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

University of South Alabama College of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ies Alabama PLLCGroup PAC ID 5395105183, 23 clinicians

Paragon Emergency Services LLCGroup PAC ID 8628153087, 401 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Ies Alabama PLLC

  • Emergency Medicine Physician
  • Foley, AL
  • NPI 1053027276
  Medicare reassignment Care Compare group NPD
• Paragon Emergency Services LLC

  • Emergency Medicine Physician
  • Winter Haven, FL
  • NPI 1912101650
  Medicare reassignment Care Compare group NPD
• Mobile Emergency Group PC

  • Emergency Medicine Physician
  • Mobile, AL
  • NPI 1932166287
  NPD (past)
• Physician Practice Partners

  • Internal Medicine Physician
  • Houma, LA
  • NPI 1326598434
  NPD (past)

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1275773665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 COURTHOUSE SQ",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365074809",
            "telephone_number": "251-580-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 COURTHOUSE SQ",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365074809",
            "telephone_number": "251-580-2555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8383 N Davis Hwy",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325146088",
            "country_code": "US",
            "telephone_number": "850-494-7979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHRISTINE",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "APRN,FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-25",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-130303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP PAYEE NUMBER",
            "identifier": "1063439065",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "011846",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630000013",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Imc North Baldwin Physician Group LLC
• Imc-Anesthesia Services, LLC
• Imc-Emergency Physicians LLC
• Imc-North Baldwin Internal Medicine LLC
• Imc-North Baldwin Primary Plus, LLC (North Baldwin Primary Plus)
• Latonya James, M.D
• Lindsey Neidhardt Jenkins, PHARMD
• Katie Joffe, PA-C
• Jennifer Johnson, SLP
• Jonathan Denton DMD PC (Save-On Dental Care)

• Family Nurse Practitioner in Bay Minette, AL
• Providers in Bay Minette, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.