Alyssa Jane Jackson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

7592 Issued in MN

Practice address

106 MN Ave
Sebeka, MN 56477

Phone

(218) 837-5333

NPI assigned

Aug 17, 2020

Last updated

Feb 5, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Astera HealthGroup PAC ID 2961395272, shared by 8 NPIs, 106 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vivie Home Health Home health agency, Alexandria, MN, CCN 248096
• Astera Health Hospital, Wadena, MN, CCN 241354

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ajackson577007@direct.centracare.com

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.

• Astera Health

  dba Astera Health Wadena Clinic

  • Rural Health Clinic/Center
  • Wadena, MN
  • NPI 1134305162
  Medicare reassignment NPD
• Astera Health

  dba Tri- County Health Care

  • Critical Access Hospital
  • Wadena, MN
  • NPI 1477545333
  Medicare reassignment NPD
• Hospice of the Red River Valley

  dba HIA Hospice

  • Community Based Hospice Care Agency
  • Fargo, ND
  • NPI 1538253646
  NPD (past)

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

• Astera Health

  dba Tri- County Health Care

  • Critical Access Hospital
  • Wadena, MN
  • NPI 1477545333
  Care Compare affiliation
• Astera Health

  dba Astera Health Ottertail Clinic

  • Rural Health Clinic/Center
  • Ottertail, MN
  • NPI 1871546663

  Hospital

  Care Compare affiliation
• Knute Nelson

  dba Knute Nelson Home Health

  • Home Health Agency
  • Alexandria, MN
  • NPI 1477676229
  Care Compare affiliation

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1487266078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MN AVE",
            "city": "SEBEKA",
            "state": "MN",
            "postal_code": "56477",
            "telephone_number": "218-837-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MN AVE",
            "city": "SEBEKA",
            "state": "MN",
            "postal_code": "56477",
            "telephone_number": "218-837-5333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2715 Highway 29 S",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "MN",
            "postal_code": "563084548",
            "country_code": "US",
            "telephone_number": "320-335-8704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ALYSSA",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R49629",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "7592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Astera Health (Astera Health Sebeka Clinic)
• Caring Hands Home Care Inc
• Kaylene Dewald
• Kristina Estabrooks
• Linda Ann Knudson
• Madison Jo Lake
• Providence Villa
• Up North Angels LLC (Up North Angels)
• Up North Angels LLC

• Family Nurse Practitioner in Sebeka, MN
• Providers in Sebeka, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.