Christopher Jackson, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3014974 Issued in KY

Practice address

1550 Highway 15 S Ste 200
Jackson, KY 41339-0714

Phone

(606) 666-8404

NPI assigned

Oct 13, 2020

Last updated

Nov 2, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 KY

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County Line Primary CareGroup PAC ID 0547691289, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• County Line Primary Care

  dba Jackson Medical Clinic Family Health Care

  • Rural Health Clinic/Center
  • Jackson, KY
  • NPI 1609378132
  Care Compare group

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1801494729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8482 HIGHWAY 315",
            "city": "BOONEVILLE",
            "state": "KY",
            "postal_code": "413149016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 HIGHWAY 15 S STE 200",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413390714",
            "telephone_number": "606-666-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHRISTOPHER",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-13",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3014974",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3014974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackson Physician Corp (Dba Jackson Urology)
• Jackson Physician Corp (Jackson Orthopedic Clinic)
• Jackson Physician Corp (Jackson Foot and Ankle Clinic)
• Jackson Physician Corp
• Jackson Womens Care
• Jamco of Ky. Inc. (Jackson Physical Therapy)
• Jett SNF Operations LLC (Breathitt Health & Rehabilitation)
• John a Jones O.D., P.S.C.
• Aaron William Johnson, D.O.
• Alexandria Erin Whitt Johnson, PHARMD

• Family Nurse Practitioner in Jackson, KY
• Providers in Jackson, 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 Nov 2, 2020; 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.