Antonia Jackson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.0030393 Issued in OH

Practice address

1 N Brookwood Ave
Hamilton, OH 45013-1209

Phone

(139) 814-2035

NPI assigned

Jan 7, 2014

Reactivated

Jan 13, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, IN, GA3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: antonia.jackson@779530956636164.direct.elationemr.com
• Direct secure messaging: antonia.jackson@521861120327684.direct.elationemr.com
• Direct secure messaging: ajackson2814038@direct.bsmhealth.org
• FHIR API: https://api.platform.athenahealth.com/15350/brand/1/csg/1/fhir/r4

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.

• CG Medical Associates Inc

  • Urgent Care Clinic/Center
  • Cincinnati, OH
  • NPI 1982903951
  Medicare reassignment NPD
• First Priority Urgent Care LLC

  • Urgent Care Clinic/Center
  • Trotwood, OH
  • NPI 1902343031
  Medicare reassignment NPD
• Mercy Health Urgent Care LLC

  • Family Medicine Physician
  • Milford, OH
  • NPI 1588390942
  Medicare reassignment NPD
• The Little Clinic of Ohio LLC

  • Family Nurse Practitioner
  • Cincinnati, OH
  • NPI 1982761896
  Medicare reassignment NPD
• Vpa PC

  • Family Medicine Physician
  • Middleburg Heights, OH
  • NPI 1932386059
  Medicare reassignment NPD
• Community Care Health Network LLC

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  OH

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  OH

  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  GA

  Medicare reassignment
• Vpa PC

  • Family Medicine Physician
  • Moraine, OH
  • NPI 1346254281
  NPD
• Vpa PC

  • Clinical Social Worker
  • Maumee, OH
  • NPI 1952929630
  NPD
• Vpa PC

  • Family Medicine Physician
  • Brentwood, TN
  • NPI 1578363362
  NPD

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1356763593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 N BROOKWOOD AVE",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450131209",
            "telephone_number": "139-814-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 N BROOKWOOD AVE",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450131209",
            "telephone_number": "139-814-2035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7259 S Bingham Junction Blvd",
            "address_purpose": "LOCATION",
            "city": "Midvale",
            "state": "UT",
            "postal_code": "840474860",
            "country_code": "US",
            "telephone_number": "800-453-3030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANTONIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-07",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "deactivation_date": "2019-10-09",
        "reactivation_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "398426",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0030393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iyami & Grace Maternal Health Foundation LLC
• Iyp Marketing Concepts, LLC
• J B Winters DO LLC
• Jessica Jacinto Martinez
• Anecia D Jackson
• Cynthia Lee Jackson, LPN
• Dominiqe Alexis Jackson
• Hannah Jackson, OTR/L
• Jacqueline E Jackson, BSW
• Joshua Jackson

• Family Nurse Practitioner in Hamilton, OH
• Providers in Hamilton, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; 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.