Individual provider Active NPI

Linette Marie Jackson, CNRP

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1417234600
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP3394072 Issued in FL
Practice address
3627 University Blvd S
Suite 500
Jacksonville, FL 32216-4230
Phone
(904) 399-1623
Fax
(904) 399-1624
NPI assigned
Nov 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 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 ARNP3394072 FL Primary

Addresses

Primary practice location

3627 University Blvd S
Suite 500
Jacksonville, FL 32216-4230

Mailing address

1001 E 2ND St
Coudersport, PA 16915-8161
Phone (814) 274-5585

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address linette.m.jackson@upmcdirect.com Direct Charles Cole Memorial Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180124001819 PA Practitioner - Nurse Practitioner 4284809195 Reassigns benefits to 1 organization
I20230530000970 NY Practitioner - Nurse Practitioner 4284809195 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delphi Healthcare PLLCGroup PAC ID 9537229661, 68 clinicians

Practice addresses (Care Compare)

116 Interstate Pkwy
Bradford, PA 16701-1036
Phone (814) 368-4143

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Delphi Hospitalist Services LLC CurrentSince Apr 17, 2023 Accepting new patients
Delphi Healthcare PLLC CurrentSince Dec 1, 2022 Accepting new patients

Locations

1001 West St
Carthage, NY 13619
Phone (315) 493-1000

845 Route 5 and 20
Irving, NY 14081
Phone (716) 593-1100

214 King St
Ogdensburg, NY 13669
Phone (315) 713-5660

1160 Chili Ave
Rochester, NY 14624
Phone (585) 330-3374

191 N Main St
Wellsville, NY 14895
Phone (585) 593-1100

116 Interstate Pkwy
Bradford, PA 16701
Phone (814) 362-8674

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1417234600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E 2ND ST",
            "city": "COUDERSPORT",
            "state": "PA",
            "postal_code": "169158161",
            "telephone_number": "814-274-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3627 UNIVERSITY BLVD S",
            "address_2": "SUITE 500",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164230",
            "telephone_number": "904-399-1623",
            "fax_number": "904-399-1624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LINETTE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CNRP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-16",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP3394072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "linette.m.jackson@upmcdirect.com",
            "affiliation": "Y",
            "endpointDescription": "UPMC Cole",
            "affiliationName": "Charles Cole Memorial Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1001 E 2nd St",
            "city": "Coudersport",
            "state": "PA",
            "country_code": "US",
            "postal_code": "16915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.