Macheri Jackson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN-244704 Issued in GA

Practice address

161 E Rivulon Blvd Ste 210
Gilbert, AZ 85297-0087

Phone

(480) 494-2465

NPI assigned

Dec 3, 2024

Last updated

Dec 3, 2024By the provider in NPPES

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 GA

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

State licenses

Practice roles

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.

• Aim Healthcare Providers Ga, PC

  • Family Medicine Physician
  • Plano, TX
  • NPI 1417805482
  NPD (past)

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

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1902622178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 LAVA LN",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302915187",
            "telephone_number": "229-256-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 E RIVULON BLVD STE 210",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970087",
            "telephone_number": "480-494-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MACHERI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-03",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN-244704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Hibbert Jackson
• Erin Marie Jackson, FNP-C
• Jacquelyn Lee Jackson, RN
• Jennica Jackson
• Lauryn Jackson, PA-C
• Mary Jackson, LPC
• Sally Fayrweather Jackson, HRN
• Starnique Antrenae Jackson
• Tahji Jackson
• Beth Louise Jaco, CPNP

• Family Nurse Practitioner in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.