Lauraine M Jackson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN098038 Issued in AZ

Practice address

3212 N Windsong Dr
Suite 200
Prescott Valley, AZ 86314-2255

Phone

(928) 583-1000

Fax

(866) 751-4157

NPI assigned

Nov 15, 2012

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

Medicare fee-for-service enrollment

Enrolled in AZ

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Craig M Rundbaken DO PLLCGroup PAC ID 8628982741, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lauraines.jackson.p1@direct.nachci.nextgenshare.com

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.

• Craig M. Rundbaken, D.O. PLLC

  • Pulmonary Disease Physician
  • Sun City West, AZ
  • NPI 1821279308
  Medicare reassignment Care Compare group NPD
• Sonoran Pulmonary and Critical Care PLLC

  • Pulmonary Disease Physician
  • Phoenix, AZ
  • NPI 1457651085
  NPD

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496793600000",
    "number": "1336483379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7782",
            "fax_number": "615-920-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3212 N WINDSONG DR",
            "address_2": "SUITE 200",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142255",
            "telephone_number": "928-583-1000",
            "fax_number": "866-751-4157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LAURAINE",
        "middle_name": "M",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2017-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN098038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Icare Health Services LLC
• Integrative Pain Centres of Prescott
• Integrative Pain Centres of Prescott
• Internal Medicine Specialists of Prescott Valley Arizona,PC
• Krista Iverson, RN
• Samantha Jacobson, PSYD
• Kavita Devi Jaikaran, DNP
• Karen M Jamison, NP
• Adrian Jantzi
• Kaylynn Nicole Janulewicz, LMT

• Family Nurse Practitioner in Prescott Valley, AZ
• Providers in Prescott Valley, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2017; 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.