Heather E Jackson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2020003588 Issued in MO

Practice address

201 Plaza Dr Ste C
Sikeston, MO 63801-5105

Phone

(573) 481-2210

Fax

(573) 481-2220

NPI assigned

Feb 19, 2020

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 MO

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Missouri Delta Medical CenterGroup PAC ID 1355252891, 134 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Missouri Delta Medical Center Hospital, Sikeston, MO, CCN 260113

Medicare enrollment (NPD)

Enrolled

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.

• Missouri Delta Medical Center

  • Internal Medicine Physician
  • Sikeston, MO
  • NPI 1508967860
  Medicare reassignment Care Compare group NPD
• Missouri Delta Medical Center

  • Community/Retail Pharmacy
  • Malden, MO
  • NPI 1578371621
  NPD

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

• Missouri Delta Medical Center

  • General Acute Care Hospital
  • Sikeston, MO
  • NPI 1831269539
  Care Compare affiliation

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1699308569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015044",
            "telephone_number": "573-471-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PLAZA DR STE C",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015105",
            "telephone_number": "573-481-2210",
            "fax_number": "573-481-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "HEATHER",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-19",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020003588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Razvan Iorga, M.D.
• Ipc Pac Healthcare Services of Missouri Inc
• Jami Lyn Irvan, LMT
• Angela Dawn Jackson, MA, CCC-SLP
• Dorothy Machelle Jackson
• Kelly Ann Jackson, FNP-BC
• Lucinda Jakubiak, DPT
• Danielle E Jansen, FNP
• Christy Lea Jaynes, M.A. CCC-SLP
• Rory Jaynes

• Family Nurse Practitioner in Sikeston, MO
• Providers in Sikeston, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.