Tommora Denice Jackson, NP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AP119152 Issued in TX

Practice address

7232 North Fwy
Fort Worth, TX 76137-2481

Phone

(817) 232-2100

NPI assigned

Jun 4, 2010

Last updated

May 14, 2015By 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

Other names 1

• Tommora Denice Tollerson Former name

Medicare fee-for-service enrollment

Enrolled in TX

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Complex Wound Solutions, LLCGroup PAC ID 8325578388, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mission Care Home Health Services Home health agency, Arlington, TX, CCN 747578
• Aviator Home Health Home health agency, Fort Worth, TX, CCN 747301

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26506/brand/1/csg/1/fhir/r4
• Direct secure messaging: tommora.jackson.1@26506.direct.athenahealth.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.

• Neighborhood House Calls PLLC

  • Primary Care Nurse Practitioner
  • Fort Worth, TX
  • NPI 1083388243
  Medicare reassignment NPD Authorized official
• Complex Wound Solutions, LLC

  • Family Nurse Practitioner
  • Casper, WY
  • NPI 1104644228

  TX

  Medicare reassignment Care Compare group NPD
• Integrative Emergency Services Physician Group PA

  • Emergency Medicine Physician
  • Fort Worth, TX
  • NPI 1285922542
  Medicare reassignment NPD
• Primary Health Physicians, PLLC

  • Urgent Care Clinic/Center
  • Denton, TX
  • NPI 1770048704
  NPD (past)

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

• All-Ages Home Health Care, LLC

  dba Mission Care Home Health Services

  • Home Health Agency
  • Arlington, TX
  • NPI 1053501528
  Care Compare affiliation
• Robnita Health Care Services Inc

  dba Aviator Home Health

  • Home Health Agency
  • Fort Worth, TX
  • NPI 1689874588
  Care Compare affiliation

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431561600000",
    "number": "1497075097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9101",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750199494",
            "telephone_number": "972-745-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7232 NORTH FWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761372481",
            "telephone_number": "817-232-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TOMMORA",
        "middle_name": "DENICE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-04",
        "last_updated": "2015-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP119152",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "697480",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TOMMORA",
            "last_name": "TOLLERSON",
            "middle_name": "DENICE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shachia Rhea Jackson
• Shana Justine Jackson, LPC-ASSOCIATE
• Sophia Jackson
• Tammy Jackson, LMSW
• Tishara A. Jackson, ED.D, LCDC, CSC
• Trenay Jackson, APRN
• Trinity Jackson
• Viney Jackson
• Daisy Sobha Jacob
• Geetha Jacob, NP

• Primary Care Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Primary Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; 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.