Sara Elizabeth Jackson, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP025637 Issued in PA

Practice address

1800 N 12TH St
Reading, PA 19604-3347

Phone

(610) 816-5728

Fax

(610) 816-5710

NPI assigned

Aug 10, 2022

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

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Haven Behavioral Services of Reading LLCGroup PAC ID 4183810807, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Penn State Health St. Joseph Hospital, Reading, PA, CCN 390096

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Haven Behavioral Services of Reading, LLC

  dba Haven Behavioral Hospital of Eastern Pennsylvania

  • Psychiatric Hospital
  • Reading, PA
  • NPI 1629384292
  Medicare reassignment Care Compare group NPD
• Berkshire Psychiatric & Behavioral Health Services, PLLC

  • Psychologist
  • Reading, PA
  • NPI 1164441382

  Psychiatric/Mental Health

  Medicare reassignment NPD

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

• St Joseph Regional Health Network

  dba Penn State Health St Joseph

  • General Acute Care Hospital
  • Reading, PA
  • NPI 1699734665
  Care Compare affiliation

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1720716475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1929 LINCOLN HWY E",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176023347",
            "telephone_number": "762-571-7397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N 12TH ST",
            "city": "READING",
            "state": "PA",
            "postal_code": "196043347",
            "telephone_number": "610-816-5728",
            "fax_number": "610-816-5710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1929 Lincoln Hwy E",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176023347",
            "country_code": "US",
            "telephone_number": "762-571-7397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SARA",
        "middle_name": "ELIZABETH",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP025637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "2L6567",
            "identifier": "MEDICARE",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104140610-0002",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjackson@havenllc.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1800 N 12th St",
            "city": "Reading",
            "state": "PA",
            "country_code": "US",
            "postal_code": "196043347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• J M Winston Radiology Associates Inc
• J P Lee, Urology LTD
• Janet A Jackson, CRNP
• Lindsey Maureen Jackson, FNP-BC
• Nikol Leigh Jackson, LSW
• Daria Jacobson, CRNP
• Sreenath Jagannathan, DO
• Bina Jain, MD
• Allison Elizabeth Jakavick, DPT
• Branden Roger Jambeau, M.ED, LBS, BCBA

• Psychiatric/Mental Health Nurse Practitioner in Reading, PA
• Providers in Reading, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.