Lawanda Bevel Jackson, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

9365258 Issued in FL

Practice address

13575 58TH St N Ste 200
Clearwater, FL 33760-3739

Phone

(813) 563-1465

Fax

(813) 336-8426

NPI assigned

May 18, 2022

Last updated

Jan 30, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 FL

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Better My Future

  • Psychiatric/Mental Health Nurse Practitioner
  • St Petersburg, FL
  • NPI 1124849856

  Single Specialty

  Medicare reassignment NPD Authorized official
• Dr Luisa Vega DNP LLC

  • Nurse Practitioner
  • Lake Mary, FL
  • NPI 1497123319

  Single Specialty

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1558008789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13575 58TH ST N STE 200",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337603739",
            "telephone_number": "813-563-1465",
            "fax_number": "813-336-8426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13575 58TH ST N STE 200",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337603739",
            "telephone_number": "813-563-1465",
            "fax_number": "813-336-8426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LAWANDA",
        "middle_name": "BEVEL",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-18",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "9365258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James William Jackson III, D.D.S.
• Kellie Lyn Jackson, PTA
• Kim Jackson
• Lavett Jackson
• Lavonne Jackson
• Mackenzie Jackson
• Shanel Loree Jackson, P.T.
• Dominique Leticia Jacobs
• Stephen H Jacobs, MD
• Ronald Jacobson, MD

• Psychiatric/Mental Health Nurse Practitioner in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.
• 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.