Stephanie Hope Jackson, APRN, FNP-BC
Individual provider Active NPI Nurse Practitioner · Sutton, WV
NPI 1376972422 · NPPES record last updated Aug 24, 2022
Key facts
- NPI
- 1376972422
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- APRN79343-FNP-BC (WV)
- Practice address
- 266 Skidmore LN
Sutton, WV 26601-9271 - Phone
- (304) 765-0351
- Fax
- (304) 765-7019
- NPI assigned
- Nov 8, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 48
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Community Care of West Virginia, Inc.
Practice addresses (Care Compare)
142 Flatwoods Corner Rd
Flatwoods, WV 26621-1112
Phone (304) 924-6262
228 Kanawha Ave
Burnsville, WV 26335-7700
Phone (304) 713-3105
288 N Hill Rd
Sutton, WV 26601-1225
Phone (304) 402-2105
55 Little Birch Rd
Sutton, WV 26601-9469
Phone (304) 765-2881
700 Oakmound Rd
Clarksburg, WV 26301-9398
Phone (304) 623-3874
77 W Main St
Buckhannon, WV 26201-2236
Phone (304) 473-1440
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150723006972 | WV | Practitioner - Nurse Practitioner | 7214240027 | Reassigns benefits to 15 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN79343-FNP-BC | WV | MD | Nurse Practitioner |
Practice roles
Locations
77 W Main St
Buckhannon, WV 26201
Phone (304) 473-1440
4 Northridge Dr
Ste 118
Buckhannon, WV 26201
Phone (304) 473-1440
228 Kanawha Ave
Burnsville, WV 26335
Phone (304) 713-3105
59 Ossia Rd
Duck, WV 25063
Phone (304) 286-2838
142 Flatwoods Corner Rd
Flatwoods, WV 26621
Phone (304) 402-2023
113 5th St
Gassaway, WV 26624
Phone (304) 364-5867
797 Clinic Dr
Ivydale, WV 25113
Phone (304) 286-4200
78 Queens Alley Rd
Rock Cave, WV 26234
100 Carter Braxton Dr
Sutton, WV 26601
Phone (304) 765-2644
288 N Hill Rd
Sutton, WV 26601
Phone (304) 402-2105
55 Little Birch Rd
Sutton, WV 26601
Phone (304) 765-2881
200 Jerry Burton Dr
Sutton, WV 26601
Phone (304) 765-7331
266 Skidmore Ln
Sutton, WV 26601
Phone (304) 765-0351
149 Staunton Dr
Weston, WV 26452
Phone (304) 269-2022
Interoperability endpoints
- stephanie.jackson.1@4803.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN79343-FNP-BC | WV | Yes |
Addresses
Primary practice location
266 Skidmore LN
Sutton, WV 26601-9271
Mailing address
266 Skidmore LN
Sutton, WV 26601-9271
Phone (304) 765-0351
Other providers in Sutton, WV
- Marlee Ann Huffman
- Regina Hull
- Peggy Lou Ice
- J2 Osteopathic Medicine
- Arlene Jackson
- Jasmine Kay James
- Katie James
- Gabriella Jarrell
- Karen Sue Jarrell
- Terri Jarrell
All providers in Sutton, WV · Nurse Practitioner in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.