Martie Marie Jackson, ARNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

ARNP3050652 Issued in FL

Practice address

876 S Parsons Ave
Brandon, FL 33511-6007

Phone

(813) 653-3359

Fax

(813) 662-9639

NPI assigned

May 3, 2006

Sex

Female

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 FL

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, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Digestive Diseases Associates of Tampa Bay LLCGroup PAC ID 5496847683, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Brandon Hospital Hospital, Brandon, FL, CCN 100243
• HCA Florida South Shore Hospital Hospital, Sun City Center, FL, CCN 100259
• Tampa General Hospital Hospital, Tampa, FL, CCN 100128

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: mjackson8032@direct.tgh.org
• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Florida Hospital Physician Group Inc

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1174955256
  Medicare reassignment Care Compare group NPD
• Digestive Diseases Associates of Tampa Bay LLC

  • Gastroenterology Physician
  • Brandon, FL
  • NPI 1316057441
  Medicare reassignment Care Compare group
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD
• John Q Stauffer Mdpa

  • Gastroenterology Physician
  • Tampa, FL
  • NPI 1245453679
  NPD (past)

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

• Florida Health Sciences Center Inc

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1235196510
  Care Compare affiliation
• Galencare, Inc.

  • General Acute Care Hospital
  • Brandon, FL
  • NPI 1669427258
  Care Compare affiliation
• Sun City Hospital Inc

  • General Acute Care Hospital
  • Sun City Center, FL
  • NPI 1164476867
  Care Compare affiliation

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238112000000",
    "number": "1891753166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "876 S PARSONS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116007",
            "telephone_number": "813-653-3359",
            "fax_number": "813-662-9639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "876 S PARSONS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116007",
            "telephone_number": "813-653-3359",
            "fax_number": "813-662-9639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MARTIE",
        "middle_name": "MARIE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2009-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP3050652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J. Paonessa M.D. P.a.
• Carrie Jacka
• Ebene Jackson, RBT
• Julie Jackson, LCSW
• Manami Jackson
• Rhonda S Jackson, ARNP
• Trenichia Jackson
• Leslie Jacobi
• Jonita Jacobs, LMHC
• Logan Jacobs, MSW

• Primary Care Nurse Practitioner in Brandon, FL
• Providers in Brandon, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2009; 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.