Tina Marie Jackson, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

900192 Issued in NC

Practice address

300 Keisler Drive
Suite 204
Cary, NC 27518

Phone

(919) 233-0059

Fax

(919) 233-0343

NPI assigned

Mar 13, 2007

Last updated

Aug 8, 2024By 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 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wakemed Specialists Group LLCGroup PAC ID 2466788377, 868 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wakemed, Cary Hospital Hospital, Cary, NC, CCN 340173
• Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069

Merit-based Incentive Payment System (MIPS)

Final score

59.24 of 100Reported as group

Quality

76.05

Promoting interoperability

0

Improvement activities

40

Cost

71.42

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ackson12353@directhisp.wakemed.org
• Direct secure messaging: tjackson12353@directhisp.wakemed.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.

• Wakemed Specialists Group, LLC

  • Cardiovascular Disease Physician
  • Raleigh, NC
  • NPI 1588227839
  Medicare reassignment Care Compare group NPD
• Wakemed Specialists Group LLC

  dba WakeMed - Virtual Cardiac Rehab

  • Cardiac Rehabilitation Registered Nurse
  • Raleigh, NC
  • NPI 1063304228
  NPD
• Wakemed Specialists Group LLC

  dba WakeMed Heart & Vascular - Cary Cardiology

  • Cardiovascular Disease Physician
  • Cary, NC
  • NPI 1447852579
  NPD

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

• Wakemed

  dba Wakemed Cary Hospital

  • General Acute Care Hospital
  • Cary, NC
  • NPI 1114993086
  Care Compare affiliation
• Wakemed

  dba WakeMed Mental Health & Well-Being Hospital WakeBrook

  • Psychiatric Hospital Unit
  • Raleigh, NC
  • NPI 1780446302
  Care Compare affiliation
• Wakemed

  dba WakeMed Raleigh Campus

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1972579837
  Care Compare affiliation

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1639202336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 CRICKETT RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276109327",
            "telephone_number": "919-266-6565",
            "fax_number": "919-233-0343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 KEISLER DRIVE",
            "address_2": "SUITE 204",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27518",
            "telephone_number": "919-233-0059",
            "fax_number": "919-233-0343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "900192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ackson12353@directHISP.wakemed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "XML",
            "address_1": "300 Keisler Drive",
            "address_2": "Suite 204",
            "city": "Cary",
            "state": "NC",
            "country_code": "US",
            "postal_code": "27518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brian Jackson
• Jaya Jackson, RBT
• Kathryn Marie Jackson, MSW, LCSW
• Lari Meeker Jackson, PSYD
• Margaret Elizabeth Jackson, MSSW, LCSW, ACSW
• Jacobs and Van Cleeff Internal Medicine, PC
• Benjamin Jacobs, DPT
• Elizabeth Jacobs, BACHELOR OF SCIENCE
• James William Jacobs, MD
• Kimberly Ruth Jacobs, HEALTH COACH

• Adult Health Nurse Practitioner in Cary, NC
• Providers in Cary, NC by specialty
• Adult Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.