Individual provider Active NPI

Tokeysha Johnson Jackson, CRNP

  • Primary Care Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1316191968
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
1-108932 Issued in AL
Practice address
Community Care Building 908 20TH Street
Birmingham, AL 35294-1047
Phone
(205) 934-1917
NPI assigned
Nov 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1-108932 AL
Primary Care Nurse Practitioner 363LP2300X 1-108932 AL Primary

Addresses

Primary practice location

Community Care Building 908 20TH Street
Birmingham, AL 35294-1047

Mailing address

709 Griswold Rd
Fairfield, AL 35064-2808

Other practice location 1

2250 Hickory Rd
Suite 240
Plymouth Meeting, PA 19462-1047
Phone (610) 834-1122 ext. 187

Other practice location 2

1509 6th Ave S
Birmingham, AL 35233-1601
Phone (205) 930-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20190507002155 AL Practitioner - Nurse Practitioner 8224370507 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1509 6TH Ave S
Birmingham, AL 35233-1601
Phone (205) 930-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-108932ALMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Jun 13, 2019 Accepting new patients
Cooper Green Mercy Health Services Authority an Affiliate of Uab CurrentSince Sep 1, 2023 Accepting new patients
Cooper Green Mercy Health Services Authority an Affiliate of Uab CurrentSince Sep 1, 2023 Accepting new patients
University of Alabama at Birmingham CurrentSince Jun 13, 2019 Accepting new patients
University of Alabama at Birmingham Current Accepting new patients
University of Alabama at Birmingham CurrentSince Jun 13, 2019 Accepting new patients
Jefferson County Commission Past Accepting new patients
University of Alabama at Birmingham Past Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

908 20th St S
Birmingham, AL 35205
Phone (205) 934-4108

1509 6th Ave S
Birmingham, AL 35233
Phone (205) 930-3200

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1316191968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 GRISWOLD RD",
            "city": "FAIRFIELD",
            "state": "AL",
            "postal_code": "350642808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COMMUNITY CARE BUILDING 908 20TH STREET",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352941047",
            "telephone_number": "205-934-1917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2250 Hickory Rd",
            "address_2": "Suite 240",
            "address_purpose": "LOCATION",
            "city": "Plymouth Meeting",
            "state": "PA",
            "postal_code": "194621047",
            "country_code": "US",
            "telephone_number": "610-834-1122 x187",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1509 6th Ave S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331601",
            "country_code": "US",
            "telephone_number": "205-930-3200",
            "fax_number": "205-521-5526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON JACKSON",
        "first_name": "TOKEYSHA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-10",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-108932",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AL",
            "license": "1-108932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.