Kristine Jackson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

LG-000450 Issued in DE

Practice address

114 Sandhill Dr
Suite 101
Middletown, DE 19709-5805

Phone

(203) 378-4779

Fax

(302) 378-3789

NPI assigned

Jan 29, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christiana Hospital Hospital, Newark, DE, CCN 080001

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Christiana Care Health Services Inc

  • Hospitalist Physician
  • Newark, DE
  • NPI 1245474329
  Medicare reassignment Care Compare group NPD
• Delaware Hospice, Inc

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Newark, DE
  • NPI 1821361072
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christiana Care Health Services, Inc.

  • General Acute Care Hospital
  • Wilmington, DE
  • NPI 1134194038
  Care Compare affiliation

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1467690487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 SANDHILL DR",
            "address_2": "SUITE 101",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197095805",
            "telephone_number": "203-378-4779",
            "fax_number": "302-378-3789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 SANDHILL DR",
            "address_2": "SUITE 101",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197095805",
            "telephone_number": "203-378-4779",
            "fax_number": "302-378-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KRISTINE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-29",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-000450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imperial Psychiatric Services LLC
• Integrated Health, LLC
• Internal Medicine of Delaware, LLC
• Aaron Jackson, PT
• Cordele Jackson, DPT, PT
• Nikita Yvette Jackson, NBC-HWC
• Shelby Jackson, LPCMH
• Nayana Jacob
• Jang Endodontics
• Austin Jang, DDS

• Family Nurse Practitioner in Middletown, DE
• Providers in Middletown, DE by specialty
• Family Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.