Teniola Yetunde Jackson

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

1193049 Issued in TX

Practice address

13523 Hargrave Rd Ste 100
Houston, TX 77070-3829

Phone

(346) 654-3463

NPI assigned

Mar 24, 2025

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 TX

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pristine OB-GYN Care PLLCGroup PAC ID 8527221662, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CJJFDD/Endpoint/CJJFDD

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.

• Pristine OB-GYN Care PLLC

  • Medical Specialty Clinic/Center
  • Houston, TX
  • NPI 1346514619
  Medicare reassignment Care Compare group NPD
• Pristine Pediatrics & Family Medicine Clinic LLC

  • Pediatrics Physician
  • Houston, TX
  • NPI 1427521525
  Medicare reassignment NPD

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1295536159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25906 AURA LAKE LN",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774061722",
            "telephone_number": "832-283-9308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13523 HARGRAVE RD STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770703829",
            "telephone_number": "346-654-3463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26717 westheimer pwky",
            "address_2": "suite 103",
            "address_purpose": "LOCATION",
            "city": "KATY",
            "state": "TX",
            "postal_code": "77494",
            "country_code": "US",
            "telephone_number": "832-838-4031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TENIOLA",
        "middle_name": "YETUNDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1193049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Syreena A. Jackson, PT, DPT,OCS
• Taicaeria Ta'Rai Jackson
• Tametria Jackson
• Tatiana Jackson
• Tausha Jackson, LMT
• Thanesha Jackson
• Tiffani Theressa Jackson
• Timothy A. Jackson, M.D. PHD
• Tonia Lynette Jackson, FNP-C
• Valerie Darice Jackson, PH D

• Primary Care Nurse Practitioner in Houston, TX
• Providers in Houston, TX by specialty
• Primary Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; 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.