Individual provider Active NPI

Dallas Taylor Jackson

  • Family Nurse Practitioner
  • Rehoboth Beach, DE
National Provider Identifier
1437836665
Registry record updated Dec 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LG-0012827 Issued in DE
Practice address
19277 Plantation Rd
Rehoboth Beach, DE 19971-4411
Phone
(302) 567-1500
NPI assigned
Jun 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X LG-0012827 DE Primary
Registered Nurse 163W00000X L1-0055490 DE

Addresses

Primary practice location

19277 Plantation Rd
Rehoboth Beach, DE 19971-4411

Mailing address

19277 Plantation Rd
Rehoboth Beach, DE 19971-4411
Phone (302) 567-1500

Other practice location 1

18068 Coastal Hwy
Lewes, DE 19958-4901
Phone (302) 567-1500

Other practice location 2

90 Atlantic Ave Ste 4
Ocean View, DE 19970-9116
Phone (302) 745-7050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20240909002978 DE Practitioner - Nurse Practitioner 0648628412 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aspira HealthGroup PAC ID 4486080389, 17 clinicians

Practice addresses (Care Compare)

18068 Coastal Hwy
Lewes, DE 19958-4901
Phone (302) 567-1500

Hospital & facility affiliations

  • Beebe Medical Center Hospital, Lewes, DE, CCN 080007
  • Bayhealth Hospital, Sussex Campus Hospital, Milford, DE, CCN 080009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L1-0055490DEMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Aspira Health CurrentSince Aug 26, 2024 Accepting new patients
Atracare Walk-in LLC CurrentSince Aug 26, 2024 Accepting new patients

Locations

18068 Coastal Hwy
Lewes, DE 19958
Phone (302) 567-1500

90 Atlantic Ave
Ste 4
Ocean View, DE 19970
Phone (302) 745-7050

Interoperability endpoints

  • Direct secure messaging: dallas.jackson.1@22424.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 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": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766275200000",
    "number": "1437836665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19277 PLANTATION RD",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199714411",
            "telephone_number": "302-567-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19277 PLANTATION RD",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199714411",
            "telephone_number": "302-567-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18068 Coastal Hwy",
            "address_purpose": "LOCATION",
            "city": "Lewes",
            "state": "DE",
            "postal_code": "199584901",
            "country_code": "US",
            "telephone_number": "302-567-1500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "90 Atlantic Ave Ste 4",
            "address_purpose": "LOCATION",
            "city": "Ocean View",
            "state": "DE",
            "postal_code": "199709116",
            "country_code": "US",
            "telephone_number": "302-745-7050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DALLAS",
        "middle_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-29",
        "last_updated": "2025-12-21",
        "certification_date": "2025-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0012827",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DE",
            "license": "L1-0055490",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rehoboth Beach, DE

Sources for this page

Verify at the official NPI Registry.