Diane Kae Jackson, A.P.R.N.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

110613 Issued in NE

Practice address

727 E 1St St
Minden, NE 68959-1705

Phone

(308) 832-3400

NPI assigned

Jun 8, 2006

Last updated

Aug 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 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NE

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

Creighton University School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Kearney Co Health ServicesGroup PAC ID 8820900780, shared by 3 NPIs, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kearney County Health Services Hospital Hospital, Minden, NE, CCN 281306

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/afb10dcd-fcfe-4394-bcee-f9c44a02df40/

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.

• Alegent Creighton Clinic

  dba CHI Health Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907
  Medicare reassignment Care Compare group NPD
• Hastings Convenient Care PC

  • Urgent Care Clinic/Center
  • Hastings, NE
  • NPI 1710203054
  Medicare reassignment NPD
• Kearney Co Health Services

  dba Minden Medical Clinic

  • Rural Health Clinic/Center
  • Minden, NE
  • NPI 1205977873
  Medicare reassignment NPD
• Kearney Co Health Services

  dba Kearney County Health Services

  • Critical Access Hospital
  • Minden, NE
  • NPI 1477585958
  Medicare reassignment NPD
• Kearney Co Health Services

  dba Kearney County Health Services

  • Medicare Defined Swing Bed Hospital Unit
  • Minden, NE
  • NPI 1992846588
  NPD
• County Medical Services Inc.

  dba Main Street Medical Clinic

  • Rural Health Clinic/Center
  • Red Cloud, NE
  • NPI 1174570758
  NPD (past)
• Franklin County Memorial Hospital

  dba Main Street Medical Clinic

  • Rural Health Clinic/Center
  • Red Cloud, NE
  • NPI 1346808607
  NPD (past)

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

• Kearney Co Health Services

  dba Kearney County Health Services

  • Critical Access Hospital
  • Minden, NE
  • NPI 1477585958
  Care Compare affiliation

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1487694089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 E 1ST ST",
            "city": "MINDEN",
            "state": "NE",
            "postal_code": "689591705",
            "telephone_number": "308-832-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 E 1ST ST",
            "city": "MINDEN",
            "state": "NE",
            "postal_code": "689591705",
            "telephone_number": "308-832-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DIANE",
        "middle_name": "KAE",
        "credential": "A.P.R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "110613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47600743622",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47600743612",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47600743623",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47600743621",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sean Meneghello Griggs, MD
• Amanda Rose Hall-Warburton
• Jody Ann Hudson
• Innovative Pharmacists Inc (L T Pedley Drug)
• Chad Isaacson, OTR/L
• Obadiah Luke Johnson, DPT
• Kearney Co Health Services (Minden Medical Clinic)
• Kearney Co Health Services (Minden Medical Clinic BCBS PCMH)
• Kearney Co Health Services (Kearney County Health Services)
• Kearney Co Health Services (Kearney County Health Services)

• Family Nurse Practitioner in Minden, NE
• Providers in Minden, NE by specialty
• Family Nurse Practitioner in Nebraska

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