Robert Dale Jackson, DNP, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

74218 Issued in ID

Practice address

1090 W Park PL
Coeur D Alene, ID 83814-2785

Phone

(208) 415-0299

Fax

(208) 625-2070

NPI assigned

Jun 22, 2015

Last updated

Aug 13, 2025By the provider in NPPES

Sex

Male

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 ID

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, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dirne Health Centers IncGroup PAC ID 2466353354, 82 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: robert.jackson.1@16899.direct.athenahealth.com

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.

• Dirne Health Centers, Inc.

  dba Heritage Health Main

  • Federally Qualified Health Center (FQHC)
  • Coeur d'Alene, ID
  • NPI 1285686477

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Dirne Health Centers, Inc.

  dba Heritage Health CFHL CDA

  • Federally Qualified Health Center (FQHC)
  • Coeur d'Alene, ID
  • NPI 1194397240

  Nurse Practitioner

  NPD
• Dirne Health Centers Inc

  dba Heritage Health

  • Federally Qualified Health Center (FQHC)
  • Coeur d'Alene, ID
  • NPI 1053980110
  NPD (past)

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

• Kootenai Health, Inc.

  • General Acute Care Hospital
  • Coeur d'Alene, ID
  • NPI 1992798409
  Care Compare affiliation

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1881076230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 W PARK PL",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142785",
            "telephone_number": "208-415-0299",
            "fax_number": "208-625-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 W PARK PL",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142785",
            "telephone_number": "208-415-0299",
            "fax_number": "208-625-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ROBERT",
        "middle_name": "DALE",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-22",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "74218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J.R. Haynie DDS PC (Lakeside Oral Surgery & Dental Implants)
• Kimberly Boyd Jabbes, DNP, AGPCNP-BC
• Dane William Jackson, MD
• Heidi Holman Jackson, M.D.
• Kathy Jackson
• Marileen Ann Jacobs
• Melissa A Jacobson, DC
• Jaeger Curtis Orthodontics
• Ellen Louise Jaeger, PHD LP
• Mary Alice Elizabeth Jaeger, MD

• Nurse Practitioner in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.