Kaitlyn Hansen Jackson, MSN, CPNP-PC, RN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

383070 Issued in NY

Practice address

801 Amsterdam Ave
New York, NY 10025-5752

Phone

(212) 749-1820

NPI assigned

Nov 12, 2019

Last updated

Dec 1, 2025By 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

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: kaitlyn.hansen@wfrchc.eclinicaldirectplus.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.

• William F Ryan Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • New York, NY
  • NPI 1851328199
  Medicare reassignment NPD
• William F Ryan Community Health Center Inc

  dba Ryan Health Midtown Emotional Wellness Center

  • Federally Qualified Health Center (FQHC)
  • New York, NY
  • NPI 1043079064
  NPD
• Ryan-Chelsea Clinton Community Health Center

  • Federally Qualified Health Center (FQHC)
  • New York, NY
  • NPI 1215978960
  NPD (past)

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1538704622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W 97TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256450",
            "telephone_number": "347-893-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100255752",
            "telephone_number": "212-749-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KAITLYN",
        "middle_name": "HANSEN",
        "name_prefix": "Mrs.",
        "credential": "MSN, CPNP-PC, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-12",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerrold Jackson, LMSW
• John Jackson, M.D.
• John James Jackson, LMSW
• Jonathan M Jackson, PHD
• Julie Jackson, M.S, CCC-SLP
• Kay Ellen Jackson, PH. D.
• Keyanna Jackson, MD
• Krystal Jackson
• Lois Ann Jackson, D.D.S.
• Lorraine Jackson, NURSE PRACTITIONER

• Pediatric Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.