Kayla Brockwell Jackson, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4020267 Issued in KY

Practice address

1 Audubon Plaza Dr
Louisville, KY 40217-1318

Phone

(502) 636-7225

Fax

(502) 636-8032

NPI assigned

Apr 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Kayla J Brockwell Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN, TX2 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

Merit-based Incentive Payment System (MIPS)

Final score

81.11 of 100Reported as group

Quality

63.34

Promoting interoperability

100

Improvement activities

40

Cost

73.68

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kjackson@direct.iuhealth.org

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.

• Emergency Medicine Services of TX, PLLC

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1245938729
  Medicare reassignment NPD
• Floyd Emergency Medicine Associates PC

  • Emergency Medicine Physician
  • New Albany, IN
  • NPI 1194869255
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Texas - Houston, PLLC

  • Emergency Medicine Physician
  • Plainview, TX
  • NPI 1760028740

  Nurse Practitioner

  Medicare reassignment NPD
• Indiana University Health Southern Indiana Physicians, LLC

  • Multi-Specialty Clinic/Center
  • Bloomington, IN
  • NPI 1013953983

  Nurse Practitioner

  Medicare reassignment NPD
• Community Medical Associates, Inc.

  • Multi-Specialty Clinic/Center
  • Louisville, KY
  • NPI 1306983762

  Nurse Practitioner

  NPD
• Indiana University Health Southern Indiana Physicians LLC

  • Durable Medical Equipment & Medical Supplies
  • Bloomington, IN
  • NPI 1063179844
  NPD

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

{
    "created_epoch": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1740800788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AUDUBON PLAZA DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171318",
            "telephone_number": "502-636-7225",
            "fax_number": "502-636-8032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 W 16th St",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "IN",
            "postal_code": "474213510",
            "country_code": "US",
            "telephone_number": "812-275-1381",
            "fax_number": "812-275-1299",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1850 State St",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "IN",
            "postal_code": "471504990",
            "country_code": "US",
            "telephone_number": "812-948-6742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KAYLA",
        "middle_name": "BROCKWELL",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-20",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1081653",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71009988A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009988A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4020267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjackson@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2900 W 16th St",
            "city": "Bedford",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474213510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "BROCKWELL",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jamie Kay Jackson
• Jasen Jackson
• Jeffrey N Jackson, PSYCHOLOGIST
• Jill Marie Jackson, RN
• Joseph F. Jackson Jr., AGACNP-BC
• Kelly Elaine Jackson, MS, CGC
• Keyahna Jackson
• Kim E Jackson, LMFTA
• Kristin Burch Jackson, PT, DPT, CMTPT
• Kristyn Jackson, PH.D.

• Family Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.