Angel Jackson, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1024242 Issued in TX

Practice address

5119 Beckwith Blvd Ste 105
San Antonio, TX 78249-2277

Phone

(210) 366-3700

Fax

(210) 265-1442

NPI assigned

Apr 12, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Angel Chambers Former name

Medicare fee-for-service enrollment

Enrolled in TX

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mypsych Mental Health, PLLCGroup PAC ID 5890078042, 14 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Mypsych Mental Health, PLLC

  • Psychiatry Physician
  • San Antonio, TX
  • NPI 1871962191
  Medicare reassignment Care Compare group NPD
• Anne Esquivel, PH.D., P.a.

  • Clinical Psychologist
  • San Antonio, TX
  • NPI 1679700884
  NPD (past)

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1609300102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 CENTRAL PKWY N STE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782325053",
            "telephone_number": "800-404-6050",
            "fax_number": "866-313-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5119 BECKWITH BLVD STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782492277",
            "telephone_number": "210-366-3700",
            "fax_number": "210-265-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANGEL",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-12",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1024242",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "13441",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF CHIROPRACTIC EXAMINERS",
            "identifier": "13441",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF NURSING",
            "identifier": "1024242",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGEL",
            "last_name": "CHAMBERS",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amalia Jackson
• Amari Jackson
• Amy Jackson
• Amy Fay Jackson, RN, FNP-C
• Amy Lee Jackson, LVN
• Bailie Shanae Jackson, MD
• Barry A Jackson, MS, MPT
• Bruce Jackson III
• Carlayne E Jackson, M.D.
• Carolyn L Jackson, CRNA

• Psychiatric/Mental Health Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.