Christa Jackson

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

B118673 Issued in IA

Practice address

1510 E Rusholme St
Davenport, IA 52803-2463

Phone

(563) 336-3000

Fax

(563) 344-1371

NPI assigned

Oct 1, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Nurse Midwife (CNM)

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Care IncGroup PAC ID 9830008895, 56 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cjackson635487@direct.ochin.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.

• Community Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Davenport, IA
  • NPI 1932193224
  Medicare reassignment Care Compare group NPD
• Genesis Health System

  • Clinic/Center
  • Bettendorf, IA
  • NPI 1497772008
  Medicare reassignment
• Community Health Care, Inc.

  • Clinical Medical Laboratory
  • Davenport, IA
  • NPI 1649461310
  NPD
• Genesis Health System

  • Family Medicine Physician
  • Davenport, IA
  • NPI 1477654945
  NPD
• Genesis Health System

  • Critical Access Hospital
  • De Witt, IA
  • NPI 1649368523
  NPD
• Community Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • East Moline, IL
  • NPI 1669360459
  NPD

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

{
    "created_epoch": "1285891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1760791230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W RIVER DR",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528011014",
            "telephone_number": "563-336-3000",
            "fax_number": "563-336-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 E RUSHOLME ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032463",
            "telephone_number": "563-336-3000",
            "fax_number": "563-344-1371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHRISTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-01",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IA",
            "license": "B118673",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G179008",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J&S Kelly LLC
• J&S Kelly LLC
• Tara Marie Jacks
• Jackson Recovery Centers
• Catherine DO Jackson, PHD
• Liyah Jackson
• Theresa Jackson, LMSW
• Jaclyn Jacobi, OTR/L
• Heather Jacobs, ARNP
• Justice Jacobs, LMT

• Advanced Practice Midwife in Davenport, IA
• Providers in Davenport, IA by specialty
• Advanced Practice Midwife in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.