Individual provider Active NPI

Rachael Myers Jackson, FNP-C

  • Family Nurse Practitioner
  • Granbury, TX
National Provider Identifier
1679392617
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1175095 Issued in TX
Practice address
1310 Paluxy Rd Ste 2000
Granbury, TX 76048-5655
Phone
(817) 579-3700
NPI assigned
Oct 7, 2024
Last updated
Oct 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1175095 TX Primary

Addresses

Primary practice location

1310 Paluxy Rd Ste 2000
Granbury, TX 76048-5655

Mailing address

12377 Merit Dr Ste 700
Dallas, TX 75251-2241
Phone (817) 579-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20241030001372 TX Practitioner - Nurse Practitioner 6608309539 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chot Healthcare ProvidersGroup PAC ID 2163881228, 8 clinicians

Practice addresses (Care Compare)

6100 Western PL
Suite 105
Fort Worth, TX 76107-4662
Phone (817) 870-2795

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chot Healthcare Providers Family CurrentSince Jan 19, 2026 Accepting new patients
Clinical Bridges PLLC CurrentSince Jul 7, 2025 Accepting new patients

Locations

6100 Western Pl
Ste 105
Ft Worth, TX 76107
Phone (817) 870-2795

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1728259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1679392617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12377 MERIT DR STE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512241",
            "telephone_number": "817-579-3700",
            "fax_number": "210-595-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 PALUXY RD STE 2000",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760485655",
            "telephone_number": "817-579-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "RACHAEL",
        "middle_name": "MYERS",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-07",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1175095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

Verify at the official NPI Registry.