Marlischa Jackson

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP136994 Issued in TX

Practice address

21970 Bulverde Rd Ste 103
San Antonio, TX 78259-2179

Phone

(210) 625-5708

Fax

(888) 227-1442

NPI assigned

Mar 14, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Concussive and Cognitive Diagnostics PLLC

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1689243156
  Medicare reassignment
• Doctors on the Go PLLC

  • Family Nurse Practitioner
  • San Antonio, TX
  • NPI 1750035242
  Medicare reassignment
• Pediatric Heroes Primary Care Clinic, PLLC

  • Pediatric Nurse Practitioner
  • San Antonio, TX
  • NPI 1790374932

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1801399019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21970 BULVERDE RD STE 103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782592179",
            "telephone_number": "210-625-5708",
            "fax_number": "888-227-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21970 BULVERDE RD STE 103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782592179",
            "telephone_number": "210-625-5708",
            "fax_number": "888-227-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MARLISCHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-14",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP136994",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP136994",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP136994",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lacey Janee Jackson
• Lance Elliot Jackson, M.D., F.A.C.S.
• Learrionn Chanae Jackson, LVN
• Lindsey Jackson, LPC
• Loria Janelle Jackson
• Megan D Jackson, APRN FNP-C
• Melanie Jackson
• Nykara Jackson
• Quianna K Jackson, DC
• Rachel Jackson, LVN

• Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.