Brittany Ann Jackson, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3015177 Issued in KY

Practice address

1143 Fairway St
Suite 103
Bowling Green, KY 42103-2452

Phone

(812) 901-6881

Fax

(812) 285-8392

NPI assigned

Apr 15, 2015

Last updated

Sep 29, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Vanderbilt University School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lake Substance Abuse Solutions LLCGroup PAC ID 8123440401, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake Substance Abuse Solutions LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jeffersonville, IN
  • NPI 1124598669

  KY

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1477949576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1143 FAIRWAY ST",
            "address_2": "SUITE 103",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421032452",
            "telephone_number": "812-901-6881",
            "fax_number": "812-285-8392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1143 FAIRWAY ST",
            "address_2": "SUITE 103",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421032452",
            "telephone_number": "812-901-6881",
            "fax_number": "812-285-8392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1113 Murfreesboro Rd Ste 319",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "TN",
            "postal_code": "370641312",
            "country_code": "US",
            "telephone_number": "615-790-0567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRITTANY",
        "middle_name": "ANN",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2023-09-29",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "240639",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3015177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridget L Isenberg, M.S., CCC-SLP
• Jataun L Isenhower, APRN
• Erin Lynn Iverson, APRN, FNP-BC
• J. Andrew Craycroft D.M.D. Inc.
• J. Scott Barbee, DMD, PSC (Pediatric Dentistry of Bowling Green)
• Canon Peyton Jackson, BS
• Darlasue Katrice Jackson, SLP
• Dolores Jackson
• Eli O. Jackson, D.M.D.
• Kevin Ryan Jackson, O.D.

• Psychiatric/Mental Health Nurse Practitioner in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.
• 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.