Individual provider Active NPI

Elizabeth Marie Jackson, NP

  • Family Nurse Practitioner
  • Apopka, FL
National Provider Identifier
1619413861
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
230181 Issued in LA
Practice address
2100 Ocoee Apopka Rd
Apopka, FL 32703-9210
Phone
(407) 889-1000
NPI assigned
Jan 12, 2017
Last updated
May 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 22453 TN
Family Nurse Practitioner 363LF0000X 22453 TN
Family Nurse Practitioner 363LF0000X APRN11024679 FL
Family Nurse Practitioner 363LF0000X 230181 LA Primary

Addresses

Primary practice location

2100 Ocoee Apopka Rd
Apopka, FL 32703-9210

Mailing address

1735 Overdale Dr NW
Cleveland, TN 37312-2586
Phone (423) 715-9858

Other practice location 1

2305 Chambliss Ave NW
Cleveland, TN 37311-3847
Phone (423) 715-9858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, FL, NC, SC, GA, LA6 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 6

Enrollment IDStateProvider typePAC IDDetails
I20170619002626 TN Practitioner - Nurse Practitioner 7012285844 Reassigns benefits to 9 organizations
I20230606001473 FL Practitioner - Nurse Practitioner 7012285844 Reassigns benefits to 4 organizations
I20230614000774 NC Practitioner - Nurse Practitioner 7012285844 Reassigns benefits to 3 organizations
I20230616002006 SC Practitioner - Nurse Practitioner 7012285844 Reassigns benefits to 2 organizations
I20230706002663 GA Practitioner - Nurse Practitioner 7012285844 Reassigns benefits to 4 organizations
I20241007002355 LA Practitioner - Nurse Practitioner 7012285844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Services of Zephyrhills PAGroup PAC ID 6204924921, 51 clinicians
Hospital Medicine Services of Tennessee PCGroup PAC ID 9234432881, 157 clinicians
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

1 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 844-7000

106 Medical Ctr Blvd
Fayetteville, TN 37334-2684
Phone (931) 438-1100

1201 Bishop St
Union City, TN 38261-5403
Phone (731) 885-2410

1350 Walton Way
Augusta, GA 30901-2612
Phone (706) 722-9011

1735 Overdale Dr NW
Cleveland, TN 37312-2586
Phone (800) 424-3672

1924 Alcoa Hwy
Knoxville, TN 37920-1511
Phone (865) 544-9000

2305 Chambliss Ave NW
Cleveland, TN 37311-3847
Phone (423) 559-6000

509 Biltmore Ave
Asheville, NC 28801-4601
Phone (828) 213-1111

5959 Park Ave
Memphis, TN 38119-5200
Phone (901) 765-1000

601 E Altamonte Dr
Altamonte SPG, FL 32701-4802
Phone (407) 303-2200

6300 Main St
Zachary, LA 70791-4037
Phone (225) 658-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
22453TNMDNurse Practitioner
APRN11024679FLMDFamily Nurse Practitioner
230181LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
App of Tennessee Ed, PLLC Nurse Practitioner CurrentSince Nov 11, 2019 Accepting new patients
Southeastern Hospitalist Services PC Nurse Practitioner CurrentSince Jul 1, 2023 Accepting new patients
Emergency Coverage Services, PC Nurse Practitioner CurrentSince Sep 1, 2023 Accepting new patients
Southeastern Physician Services PC Nurse Practitioner CurrentSince Apr 11, 2017 Accepting new patients
Southeastern Medical Group, PC Nurse Practitioner CurrentSince Oct 1, 2024 Accepting new patients
Southeastern Emergency Physicians LLC Nurse Practitioner CurrentSince Sep 12, 2023 Accepting new patients
App of Tennessee HM, PLLC Nurse Practitioner CurrentSince Nov 11, 2019 Accepting new patients
Emergency Coverage, LLC Nurse Practitioner CurrentSince May 3, 2023 Accepting new patients
South Central Physicians PLLC Family CurrentSince Jan 15, 2022 Accepting new patients
Hospital Medicine Services of Tennessee PC Nurse Practitioner CurrentSince Dec 11, 2025 Accepting new patients
Hospital Physician Services of Florida PA Nurse Practitioner CurrentSince Jan 1, 2025 Accepting new patients
Southeastern Emergency Services P C Nurse Practitioner CurrentSince Apr 11, 2018 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation Nurse Practitioner CurrentSince Jul 1, 2023 Accepting new patients
Florida Emergency Physicians Kang and Associates MD LLC CurrentSince Jul 1, 2023 Accepting new patients
Acs Primary Care Physicians - Southeast PC Nurse Practitioner CurrentSince Jul 1, 2023 Accepting new patients

Locations (25 of 34)

601 E Altamonte Dr
Altamonte Springs, FL 32701
Phone (407) 303-2200

2100 Ocoee Apopka Rd
Apopka, FL 32703
Phone (407) 607-7000

1909 E Highway 50
Clermont, FL 34711
Phone (352) 717-3800

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

2626 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 325-5000

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

1900 Tebeau St
Waycross, GA 31501
Phone (912) 283-3030

6300 Main St
Zachary, LA 70791
Phone (225) 570-2618

509 Biltmore Ave
Asheville, NC 28801
Phone (828) 213-2325

260 Hospital Dr
Brevard, NC 28712
Phone (828) 883-5286

124 One Center Ct
Franklin, NC 28734
Phone (828) 369-4214

250 Hospital Dr
Highlands, NC 28741
Phone (336) 248-5161

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

288 S Ridgecrest Ave
Rutherfordton, NC 28139
Phone (252) 808-6000

1000 Medical Center Dr
Hardeeville, SC 29927
Phone (843) 784-8138

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

9400 Rhea County Hwy
Dayton, TN 37321
Phone (423) 285-5220

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1619413861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 OVERDALE DR NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373122586",
            "telephone_number": "423-715-9858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 OCOEE APOPKA RD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327039210",
            "telephone_number": "407-889-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2305 Chambliss Ave NW",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "TN",
            "postal_code": "373113847",
            "country_code": "US",
            "telephone_number": "423-715-9858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-12",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "22453",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22453",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11024679",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "230181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apopka, FL

Sources for this page

Verify at the official NPI Registry.