Susan Caprice Jackson, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ15059000 Issued in NJ

Practice address

14 Westminster Dr
Lumberton, NJ 08048-5064

Phone

(917) 400-5108

NPI assigned

Apr 20, 2024

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 NJ

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Moonshot Psychiatric Nurse Practitioner PCGroup PAC ID 9335589696, 79 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Moonshot Psychiatric Nurse Practitioner PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Seattle, WA
  • NPI 1669158879

  NJ

  Medicare reassignment Care Compare group NPD
• Stable Community Services

  • Community/Behavioral Health Agency
  • Burlington City, NJ
  • NPI 1568885663
  Medicare reassignment NPD
• Best Care Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Lumberton, NJ
  • NPI 1871482414
  NPD Authorized official
• Grow Healthcare Group of New Jersey PC

  • Mental Health Counselor
  • Hoboken, NJ
  • NPI 1841949328
  Medicare reassignment
• Stable Community Services

  • Multi-Specialty Clinic/Center
  • Burlington City, NJ
  • NPI 1861851594
  NPD (past)

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

{
    "created_epoch": "1713571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1619722972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 WESTMINSTER DR",
            "city": "LUMBERTON",
            "state": "NJ",
            "postal_code": "080485064",
            "telephone_number": "917-400-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 WESTMINSTER DR",
            "city": "LUMBERTON",
            "state": "NJ",
            "postal_code": "080485064",
            "telephone_number": "917-400-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SUSAN",
        "middle_name": "CAPRICE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-20",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15059000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imani Counseling Service LLC
• In-Vision Optics Inc.
• Insight Mind Psychiatry LLC
• Integrity Home Health Care LLC
• Kari Jackson, DPT
• Sapna Jain-Bhalodia, D.O.
• Neal Justin Johnson, DDS
• Jennifer Jones, MA, LPC, NCC
• Arun Kachroo, M.D.
• Karen Kaighn, MD

• Psychiatric/Mental Health Nurse Practitioner in Lumberton, NJ
• Providers in Lumberton, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

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