Regina Rodgers Jackson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

902247 Issued in MS

Practice address

2861 Broad Ave
Memphis, TN 38112-2903

Phone

(901) 842-3161

NPI assigned

Mar 14, 2018

Last updated

Apr 28, 2023By 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

Medicare fee-for-service enrollment

Enrolled in MS, TN2 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 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christ Community Health Services Inc.Group PAC ID 3870402084, 61 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Christ Community Health Services Inc

  dba Christ Community Health SVCS Inc

  • Federally Qualified Health Center (FQHC)
  • Memphis, TN
  • NPI 1982686614
  Medicare reassignment Care Compare group NPD
• Tunica County Healthcare Authority

  dba Tunica Medical Clinic

  • Rural Health Clinic/Center
  • Tunica, MS
  • NPI 1245360148
  Medicare reassignment NPD
• Christ Community Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Jackson, TN
  • NPI 1871299297
  NPD
• Tunica County Healthcare Authority

  dba Tunica Resorts Medical Clinic

  • Rural Health Clinic/Center
  • Tunica Resorts, MS
  • NPI 1629164512
  NPD
• Tunica County Healthcare Authority

  dba Tunica Medical Clinic Infusion Center

  • Clinic/Center
  • Tunica, MS
  • NPI 1811618887
  NPD
• Christ Community Health Services Inc

  dba CHRIST COMM HEALTH SVS- Broad Ave Pharmacy

  • Community/Retail Pharmacy
  • Memphis, TN
  • NPI 1891837290
  NPD (past)
• Cornerstone Women's Center, PLLC

  • Obstetrics & Gynecology Physician
  • Olive Branch, MS
  • NPI 1740316470
  NPD (past)

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1679076764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2861 BROAD AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381122903",
            "telephone_number": "901-842-3161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2861 BROAD AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381122903",
            "telephone_number": "901-842-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "REGINA",
        "middle_name": "RODGERS",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-14",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Milissa Jackson, D.PH.
• Nevonda Venice Jackson, PHARM.D.
• Otis Jackson Jr.
• Pamela A Jackson
• Rasheedah Jackson
• Ricky Jackson
• Ruth Jackson, APN
• Scott Christian Jackson
• Shandrika Jackson, RN
• Shironda D Jackson, LBSW

• Family Nurse Practitioner in Memphis, TN
• Providers in Memphis, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; 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.