Monica N. Jackson, APRN

Primary specialty

Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X

License

111164 Issued in NE

Practice address

707 N 190TH PLZ
Elkhorn, NE 68022-3974

Phone

(402) 815-6428

Fax

(402) 815-1565

NPI assigned

Jul 22, 2010

Last updated

Dec 13, 2013By 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 identifiers 3

Medicare fee-for-service enrollment

Enrolled in NE

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

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: monica.jackson@direct.nmhs.org

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.

• Nebraska Methodist Hospital

  • Emergency Medicine Physician
  • Omaha, NE
  • NPI 1689628372
  Medicare reassignment NPD
• Unmc Physicians

  • Multi-Specialty Clinic/Center
  • Omaha, NE
  • NPI 1417912114
  Medicare reassignment NPD
• Nebraska Methodist Hospital

  dba Methodist Hospital

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1427147883
  NPD

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1598078297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2797",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681032797",
            "telephone_number": "402-354-4230",
            "fax_number": "402-354-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N 190TH PLZ",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680223974",
            "telephone_number": "402-815-6428",
            "fax_number": "402-815-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MONICA",
        "middle_name": "N.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-22",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "NE",
            "license": "111164",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "59897",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598078297",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025866100",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN MEDICAL LICENSE",
            "identifier": "111164",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayvon Izadi, MD
• Ariona Jackson
• Jeanette Ann Jackson
• Kristin Jackson
• Matt J Jackson, PLHMP
• Virgil Jackson
• Rebecca Lee Jacobi, M.D.
• Carissa Marie Jaeger, PTA
• Korrinda K Jamieson, ED.S
• Ajoy K Jana, M.D.

• Critical Care Neonatal Nurse Practitioner in Elkhorn, NE
• Providers in Elkhorn, NE by specialty
• Critical Care Neonatal Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; 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.