Ronnalyn Jackson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP131672 Issued in TX

Practice address

11619 Shadow Creek Pkwy # 100
Pearland, TX 77584-7262

Phone

(713) 461-2915

Fax

(713) 461-5307

NPI assigned

Aug 9, 2016

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

Electronic endpoints 2

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Villagemd of Southeast Texas PAGroup PAC ID 4587947346, 217 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Villagemd of Southeast Texas, PA

  • Family Medicine Physician
  • Houston, TX
  • NPI 1841643327
  Medicare reassignment Care Compare group NPD
• Villagemd of Southeast Texas, PA

  • Family Medicine Physician
  • Houston, TX
  • NPI 1942857982
  NPD

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

• Memorial Hermann Health System

  • Radiology Clinic/Center
  • Houston, TX
  • NPI 1013948553

  Hospital

  Care Compare affiliation
• Memorial Hermann Health System

  • Radiology Clinic/Center
  • The Woodlands, TX
  • NPI 1275564858

  Hospital

  Care Compare affiliation
• Memorial Hermann Health System

  • Radiology Clinic/Center
  • Houston, TX
  • NPI 1407959448

  Hospital

  Care Compare affiliation
• Memorial Hermann Health System

  • Radiology Clinic/Center
  • Friendswood, TX
  • NPI 1508896267

  Hospital

  Care Compare affiliation
• Memorial Hermann Health System

  • Radiology Clinic/Center
  • Pearland, TX
  • NPI 1669402335

  Hospital

  Care Compare affiliation
• Memorial Hermann Health System

  • General Acute Care Hospital
  • Houston, TX
  • NPI 1730132234
  Care Compare affiliation

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1326592247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392929",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152519900",
            "telephone_number": "713-461-2915",
            "fax_number": "713-461-5307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11619 SHADOW CREEK PKWY # 100",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847262",
            "telephone_number": "713-461-2915",
            "fax_number": "713-461-5307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6122 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Pearland",
            "state": "TX",
            "postal_code": "775817804",
            "country_code": "US",
            "telephone_number": "713-461-2915",
            "fax_number": "713-461-5307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "RONNALYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-09",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP131672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ronnalyn.jackson.1@13711.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11619 Shadow Creek Pkwy # 100",
            "city": "Pearland",
            "state": "TX",
            "country_code": "US",
            "postal_code": "775847262",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ronnalyn.jackson.1@13711.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6122 Broadway St",
            "city": "Pearland",
            "state": "TX",
            "country_code": "US",
            "postal_code": "775817804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Megan Bender Jackson, DDS
• Michelle Stibora Jackson, PTA
• Milan Jackson
• Natalie Sharron Jackson, LPC
• Natasha Jackson, PHARM.D
• Shannon Jackson
• Varughese Thekkecharuvil Jacob, MSW
• Robin Jacobs-Rodriguez, D.C.
• Cottrell Lamar Jacobs, LPC
• Gold Jacobs

• Family Nurse Practitioner in Pearland, TX
• Providers in Pearland, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.