Inaisha Marie Jackson, APN

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

26NJ00625000 Issued in NJ

Practice address

Rutgers, University Behavioral Health Care
Bates Building, 2ND Floor
Trenton, NJ 08625863

Phone

(609) 292-9700

NPI assigned

Mar 16, 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

Other names 1

• Inaisha M Jackson Professional name

Medicare fee-for-service enrollment

Enrolled in PA

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

Spectrum Health Services IncGroup PAC ID 0840242467, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: inaisha.jackson.1@20090.direct.athenahealth.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.

• Spectrum Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1265866107
  Medicare reassignment Care Compare group NPD
• Optimum Health Solutions

  • Nurse Practitioner
  • Philadelphia, PA
  • NPI 1609648849
  NPD Authorized official
• Optimum Health Solutions

  • Nurse Practitioner
  • Philadelphia, PA
  • NPI 1982478939
  NPD Authorized official
• Spectrum Health Services, Inc.

  • Community/Retail Pharmacy
  • Philadelphia, PA
  • NPI 1164300901
  NPD
• Spectrum Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1881629012
  NPD (past)

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

• Presbyterian Medical Center of the University of Pennsylvania Health S

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1245207521
  Care Compare affiliation

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1386005460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 WISSAHICKON AVE APT A1103",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191445261",
            "telephone_number": "862-520-9487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RUTGERS, UNIVERSITY BEHAVIORAL HEALTH CARE",
            "address_2": "BATES BUILDING, 2ND FLOOR",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "08625863",
            "telephone_number": "609-292-9700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 Bergen St",
            "address_2": "Stanley S. Bergen Building",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071073001",
            "country_code": "US",
            "telephone_number": "973-972-4307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "INAISHA",
        "middle_name": "MARIE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-16",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ00625000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "INAISHA",
            "last_name": "JACKSON",
            "middle_name": "M",
            "credential": "APN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Zinovy Izgur, MD
• J & K Helping Hands
• J. Michael Smith, M.D., PA
• Majid Jaberzadeh Ansari
• David Isaac Jackson, M.S.ED.
• Kayla Carol Jackson
• Nykia Jackson
• Qiana Jackson
• Shanice Elizabeth Nyamesem Jackson
• Tanika Jackson

• Primary Care Nurse Practitioner in Trenton, NJ
• Providers in Trenton, NJ by specialty
• Primary Care Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.