Teresa Lynne Jackson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5377626021 Issued in KS

Practice address

118 N Summit St
Arkansas City, KS 67005-2258

Phone

(620) 506-5005

Fax

(620) 506-5002

NPI assigned

May 3, 2017

Last updated

Oct 4, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• SCK Health Hospital, Arkansas City, KS, CCN 170779

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FJHFCD
• Direct secure messaging: teresajackson@amh.ssdirect.aprima.com

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.

• A-1 IV Rehydration Clinic and Lounge

  • Family Nurse Practitioner
  • Wichita, KS
  • NPI 1932806783
  Medicare reassignment NPD Authorized official
• Neurology Consultants of Kansas LLC

  • Neurology Physician
  • Wichita, KS
  • NPI 1760474936
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Central Kansas Regional Medical Center

  dba South Central Kansas Medical Center

  • Rural Acute Care Hospital
  • Arkansas City, KS
  • NPI 1609842681
  Care Compare affiliation

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1306372842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 N SUMMIT ST",
            "city": "ARKANSAS CITY",
            "state": "KS",
            "postal_code": "670052258",
            "telephone_number": "620-660-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 N SUMMIT ST",
            "city": "ARKANSAS CITY",
            "state": "KS",
            "postal_code": "670052258",
            "telephone_number": "620-506-5005",
            "fax_number": "620-506-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TERESA",
        "middle_name": "LYNNE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-03",
        "last_updated": "2023-10-04",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "5377626021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FNP NUMBER",
            "identifier": "5377626021",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Allison Hettenbach
• Jose L Hinojosa, M.D.
• Brett Michael House, DC
• Heather L Irving, APRN
• Amber Jennings
• Stacy Jervis, FNP-BC, MED, CNRN
• Julie C Jones, PA-C
• K and D Pharmacy LLC
• Kamran Shahzada, M.D.

• Family Nurse Practitioner in Arkansas City, KS
• Providers in Arkansas City, KS by specialty
• Family Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.