Active NPI
Nickisha P Parker-Jacobs
- Family Nurse Practitioner
- Jupiter, FL
National Provider Identifier
1629943030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 11042776
- Practice address
- 210 Jupiter Lakes Blvd
Jupiter, FL 33458-7191 - Phone
- (561) 619-7620
- NPI assigned
- Oct 7, 2025
- Last updated
- Feb 27, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 11042776 | FL | Primary |
Addresses
Primary practice location
210 Jupiter Lakes Blvd
Jupiter, FL 33458-7191
Mailing address
210 Jupiter Lakes Blvd
Jupiter, FL 33458-7191
Phone (561) 619-7620
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Florida International Univ, College of Medicine, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
210 Jupiter Lakes Blvd
Suite 106
Jupiter, FL 33458-7187
Phone (561) 408-9790
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11042776 | FL | MD | Family Nurse Practitioner |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1759795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772150400000",
"number": "1629943030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 JUPITER LAKES BLVD",
"city": "JUPITER",
"state": "FL",
"postal_code": "334587191",
"telephone_number": "561-619-7620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 JUPITER LAKES BLVD",
"city": "JUPITER",
"state": "FL",
"postal_code": "334587191",
"telephone_number": "561-619-7620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER-JACOBS",
"first_name": "NICKISHA",
"middle_name": "P",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-10-07",
"last_updated": "2026-02-27",
"certification_date": "2026-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "11042776",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jupiter, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; 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.