Christa Jackson, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A004503 Issued in AR

Practice address

1 Lile CT Ste 200
Little Rock, AR 72205-6240

Phone

(501) 224-5500

Fax

(501) 224-1166

NPI assigned

Sep 9, 2015

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Beyond Wellness LLCGroup PAC ID 7517329584, 2 clinicians

Practice addresses (Care Compare)

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.

• Beyond Wellness LLC

  • Family Medicine Physician
  • Lonsdale, AR
  • NPI 1962101402
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1356719264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LILE CT STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056240",
            "telephone_number": "501-224-5500",
            "fax_number": "501-224-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LILE CT STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056240",
            "telephone_number": "501-224-5500",
            "fax_number": "501-224-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHRISTA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-09",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS STATE BOARD OF NURSING",
            "identifier": "A004503",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Jackson
• Caitlin Rachelle Jackson, APRN CPNP-PC
• Cayla-Marie Jackson, RD, LD
• Charissa Jackson
• Chicketta Jackson, MHPP
• Christine Jackson, LMSW
• Courtney Jackson, L.P.N.
• Daniel Matthew Jackson
• Darby Jackson, AU.D., CCC-A
• Deshawn Jackson

• Family Nurse Practitioner in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; 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.