Kristin Gayle Jackson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

27855 Issued in SC

Practice address

360 N Irby St
Florence, SC 29501-2808

Phone

(843) 667-9414

NPI assigned

Sep 26, 2023

Last updated

Sep 26, 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 SC

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hopehealth, Inc.Group PAC ID 4082510623, 77 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLeod Regional Medical Center-Pee Dee Hospital, Florence, SC, CCN 420051
• Musc Health Florence Medical Center Hospital, Florence, SC, CCN 420091

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hopehealth Inc

  dba HopeHealth Dental Palmetto

  • Federally Qualified Health Center (FQHC)
  • Florence, SC
  • NPI 1821002411
  Medicare reassignment Care Compare group NPD
• Hopehealth Inc

  dba Hopehealth Dental Timmonsville School Based

  • Federally Qualified Health Center (FQHC)
  • Timmonsville, SC
  • NPI 1609599679
  NPD
• Hopehealth Inc

  dba HopeHealth J. Paul Truluck School-based Health Center

  • Federally Qualified Health Center (FQHC)
  • Lake City, SC
  • NPI 1649069618
  NPD

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

• McLeod Regional Medical Center of the Pee Dee, Inc.

  • General Acute Care Hospital
  • Florence, SC
  • NPI 1699756221
  Care Compare affiliation
• Medical University Hospital Authority

  • General Acute Care Hospital
  • Florence, SC
  • NPI 1184197683
  Care Compare affiliation

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1730968090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 N IRBY ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295012808",
            "telephone_number": "843-667-9414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 N IRBY ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295012808",
            "telephone_number": "843-667-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KRISTIN",
        "middle_name": "GAYLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "27855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlene Jackson
• Cheryl Jackson
• Cradeja Shovon Jackson
• Diamond Jackson
• Haley Meharg Jackson, CPNP
• Latisha Simone Jackson, LPC
• Sholonda Jackson, RN
• William Jackson, D.O.
• Denise Jacobs, FNP
• Jennifer Langston Jacobs, RPH

• Family Nurse Practitioner in Florence, SC
• Providers in Florence, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.