Kelsey Nicole Jackson, APRN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

212635 Issued in OK

Practice address

1303 N Washington St
Weatherford, OK 73096-2443

Phone

(580) 772-2820

NPI assigned

Apr 25, 2023

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 OK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kjackson497022@direct-ehr-ssmhc.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.

• Williams Medical Group Practice, LLC

  • Family Medicine Physician
  • Lawton, OK
  • NPI 1346608809
  Medicare reassignment NPD
• Williams Medical Group Practice, LLC

  • Rural Health Clinic/Center
  • Collinsville, OK
  • NPI 1215751508
  NPD
• Cordell Memorial Hospital 0189

  • Clinic/Center
  • Cordell, OK
  • NPI 1134532344
  NPD (past)
• Cordell Memorial Hospital 0189

  • Critical Access Hospital
  • Cordell, OK
  • NPI 1750384426
  NPD (past)
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• Weatherford Hospital Authority

  • Critical Access Hospital
  • Weatherford, OK
  • NPI 1639175185
  NPD (past)

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1407544745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 N WASHINGTON ST",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730962443",
            "telephone_number": "580-772-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 N WASHINGTON ST",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730962443",
            "telephone_number": "580-772-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KELSEY",
        "middle_name": "NICOLE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "212635",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "212635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Marshall Huser IV, M.D.
• Bethany D'Ann Igo, M.ED
• Vasti Inacio
• Nicki Lynn Isaac, FSPI
• Ashley Jackson
• Sarah Nicole Johnson
• Stephanie Rose Johnson
• Jonathan Ray Long MD LLC
• Amy Lee Ann Jones
• Tatum Jones, LAT, ATC

• Family Nurse Practitioner in Weatherford, OK
• Providers in Weatherford, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.