Individual provider Active NPI

Devin Nicole Jackson

  • Gerontology Registered Nurse
  • Kerrville, TX
National Provider Identifier
1417897117
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Registered NurseTaxonomy code 163WG0600X
License
831204 Issued in TX
Practice address
3600 Memorial Blvd
Kerrville, TX 78028-5819
Phone
(830) 896-4200
NPI assigned
Mar 31, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Registered Nurse 163WG0600X 831204 TX Primary

Addresses

Primary practice location

3600 Memorial Blvd
Kerrville, TX 78028-5819

Mailing address

3600 Memorial Blvd
Kerrville, TX 78028-5819
Phone (830) 896-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
831204TXMDGerontology Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1774915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1417897117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 MEMORIAL BLVD",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285819",
            "telephone_number": "830-896-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 MEMORIAL BLVD",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285819",
            "telephone_number": "830-896-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DEVIN",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-31",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "TX",
            "license": "831204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kerrville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.