Individual provider Active NPI

Jessica Coker, APRN, FNP

  • Family Nurse Practitioner
  • Jacksboro, TX
National Provider Identifier
1386236164
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1029251 Issued in TX
Practice address
215 Chisholm TRL
Jacksboro, TX 76458-1403
Phone
(940) 567-5528
NPI assigned
Feb 3, 2021
Last updated
Feb 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1029251 TX Primary

Addresses

Primary practice location

215 Chisholm TRL
Jacksboro, TX 76458-1403

Mailing address

711 Magnolia St
Jacksboro, TX 76458-1111
Phone (940) 389-1616

Other identifiers 1

IdentifierTypeStateIssuer
1029251MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20210305000619 TX Practitioner - Nurse Practitioner 1456767045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jack County Hospital DistrictGroup PAC ID 5890768675, 20 clinicians

Practice addresses (Care Compare)

215 Chisholm TRL
Jacksboro, TX 76458-1403
Phone (940) 567-6633

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1029251TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jack County Hospital District CurrentSince Feb 1, 2021 Accepting new patients
Jack County Hospital District CurrentSince Feb 1, 2021 Accepting new patients

Locations

215 Chisholm Trl
Jacksboro, TX 76458
Phone (940) 567-5528

215 Chisholm Trl
Ste Prf
Jacksboro, TX 76458

Interoperability endpoints

  • Direct secure messaging: jessica.coker.1@11284.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1386236164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 MAGNOLIA ST",
            "city": "JACKSBORO",
            "state": "TX",
            "postal_code": "764581111",
            "telephone_number": "940-389-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 CHISHOLM TRL",
            "city": "JACKSBORO",
            "state": "TX",
            "postal_code": "764581403",
            "telephone_number": "940-567-5528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COKER",
        "first_name": "JESSICA",
        "credential": "APRN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-02-03",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1029251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029251",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksboro, TX

Sources for this page

Verify at the official NPI Registry.