Katherine Anne Jackson, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

781377 Issued in TX

Practice address

1100 W 39TH 1/2 St
Austin, TX 78756-3902

Phone

(512) 454-4545

NPI assigned

Apr 10, 2013

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 names 1

• Miss Katie Jackson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• TCH Pediatrics Inc

  • Pediatrics Physician
  • Austin, TX
  • NPI 1396385142
  NPD (past)

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395014400000",
    "number": "1275976169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W 39TH 1/2 ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787563902",
            "telephone_number": "512-454-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W 39TH 1/2 ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787563902",
            "telephone_number": "512-454-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KATHERINE",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-10",
        "last_updated": "2014-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "781377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "JACKSON",
            "prefix": "MISS",
            "credential": "PNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• John William Jackson, MD
• Jordyn Jackson
• Julie Jackson, LCSW
• Julie Elizabeth Jackson, M.D.
• Kasey B Jackson, LCSW-S
• Keri Michelle Jackson, P.T.
• Kimberly Jackson, LCSW
• Ladaun Jackson, M.A., CCC-SLP
• Lauretta E Jackson, PT
• Lisa G Jackson, R.PH.

• Pediatric Nurse Practitioner in Austin, TX
• Providers in Austin, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.