Heidi A Jackson, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F332937 Issued in NY

Practice address

261 N Roosevelt Ave
Chandler, AZ 85226-2616

Phone

(480) 305-2888

Fax

(480) 305-2889

NPI assigned

Oct 28, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in AZ

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, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DGICBA
• FHIR API: https://epicproxy.et4001.epichosted.com/APIProxyPRD/MDN/api/FHIR/R4

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.

• Good Health Medical, PLLC

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1144764432
  Medicare reassignment NPD
• Mobile NP PLLC

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1184238164
  Medicare reassignment NPD
• Good Health Medical, PLLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1023828431
  NPD
• Good Health Medical, PLLC

  • Family Medicine Physician
  • San Tan Valley, AZ
  • NPI 1063573079
  NPD
• Livn, P.C.

  • Family Medicine Physician
  • Chandler, AZ
  • NPI 1245759307
  NPD (past)
• Horizon Medical Group, P.C.

  • Family Medicine Physician
  • Goshen, NY
  • NPI 1063488179
  NPD (past)
• Horizon Medical Group, P.C.

  • Durable Medical Equipment & Medical Supplies
  • Yorktown Heights, NY
  • NPI 1386520021
  NPD (past)

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

{
    "created_epoch": "1161993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1508942954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 N MAIN ST",
            "address_2": "PO BOX 299",
            "city": "FLORIDA",
            "state": "NY",
            "postal_code": "109211133",
            "telephone_number": "845-651-1400",
            "fax_number": "845-651-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 N ROOSEVELT AVE",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262616",
            "telephone_number": "480-305-2888",
            "fax_number": "480-305-2889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Edward J Lempka Dr",
            "address_purpose": "LOCATION",
            "city": "Florida",
            "state": "NY",
            "postal_code": "109211036",
            "country_code": "US",
            "telephone_number": "845-651-1777",
            "fax_number": "845-651-3299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "HEIDI",
        "middle_name": "A",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-28",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F332937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "510793",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brianna Lynn Jack, M.A,BCBA,LBA
• Jackson Taravine Sr
• Corliss Colleen Jackson, REIKI MASTER
• Darius Jackson, PT, DPT
• Desiree Nicole Jackson
• Maryn Jackson
• Shakara Shirose Jackson
• Stephanie Ann Jackson, DO
• Terry Jackson
• Richard Douglas Jacobs Jr., M.D.

• Family Nurse Practitioner in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.