Bobbie Jackson, MSN, APRN, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

0024190222 Issued in VA

Practice address

2001 Crystal Spring Ave SW
Roanoke, VA 24014-2462

Phone

(540) 853-0100

Fax

(540) 342-9308

NPI assigned

Feb 12, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, VA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dallas Pulmonary and Critical Care PAGroup PAC ID 2163679200, 186 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Dallas Medical Center Hospital, Dallas, TX, CCN 450051

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

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 and National Provider Directory roles.

• Dallas Pulmonary & Critical Care PA

  • Critical Care Medicine (Internal Medicine) Physician
  • Dallas, TX
  • NPI 1235402728

  Acute Care

  Medicare reassignment Care Compare group NPD
• Carilion Medical Center

  • Multi-Specialty Clinic/Center
  • Roanoke, VA
  • NPI 1730123472
  Medicare reassignment NPD
• North Texas Critical Care PA

  • Critical Care Medicine (Internal Medicine) Physician
  • Dallas, TX
  • NPI 1265863542
  Medicare reassignment NPD
• Urgent Surgery Associates, P.a.

  • Trauma Surgery Physician
  • Dallas, TX
  • NPI 1326077082
  Medicare reassignment NPD
• Carilion Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Hardy, VA
  • NPI 1073324810
  NPD
• Medhealth

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1912957200
  NPD (past)

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

• Methodist Hospitals of Dallas

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1528027786
  Care Compare affiliation

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

{
    "created_epoch": "1613088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1568055481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713",
            "telephone_number": "540-224-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 CRYSTAL SPRING AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240142462",
            "telephone_number": "540-853-0100",
            "fax_number": "540-342-9308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BOBBIE",
        "credential": "MSN, APRN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-12",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1029618",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024190222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J Gordon Burch MD PLLC
• J Richard Frazier MD PC
• Tracey E. Jablonski, PTA
• Jasmine Yvette Jackson-Akers, DO
• Beja Jackson
• Brooke Ware Jackson
• John B Jackson
• Kaylyn A Jackson, PA
• Kyler Jackson
• Samuel Robert Jackson, PA

• Acute Care Nurse Practitioner in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Acute Care Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.