Individual provider Active NPI

Michelle Patricia Jackson, RN, MS, APRN-BC

  • Adult Health Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1396914552
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN-194757, NP-09434 Issued in OH
Practice address
111 S Grant Ave
Columbus, OH 43215-4701
Phone
(614) 566-9000
NPI assigned
Feb 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN-194757, NP-09434 OH Primary

Addresses

Primary practice location

111 S Grant Ave
Columbus, OH 43215-4701

Mailing address

340 E Town St
Suite 10-330
Columbus, OH 43215-4600
Phone (614) 566-8302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20080922000300 OH Practitioner - Nurse Practitioner 9133296882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

111 S Grant Ave
Columbus, OH 43215-4701

111 S Grant Ave 3Rd FL
Columbus, OH 43215-4701
Phone (614) 566-9184

393 E Town St
Columbus, OH 43215-4799

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN-194757, NP-09434OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Jan 1, 2008 Accepting new patients
Ohiohealth Corporation CurrentSince Jan 1, 2008 Accepting new patients
Orthopedic Trauma Services LTD Past Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

340 E Town St
Ste 10330
Columbus, OH 43215

111 S Grant Ave
Columbus, OH 43215
Phone (614) 461-3232

Dept L3652
Columbus, OH 43260

800 McConnell Dr
Columbus, OH 43214
Phone (614) 533-6297

5450 Frantz Rd
Ste 360
Dublin, OH 43016
Phone (614) 533-6497

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1396914552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 E TOWN ST",
            "address_2": "SUITE 10-330",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154600",
            "telephone_number": "614-566-8302",
            "fax_number": "614-566-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S GRANT AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154701",
            "telephone_number": "614-566-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MICHELLE",
        "middle_name": "PATRICIA",
        "credential": "RN, MS, APRN-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-21",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "RN-194757, NP-09434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.