Dianne Jackson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

098462 Issued in MO

Practice address

5250 New Jersey Ave
Fort Dix, NJ 08640-5017

Phone

(609) 562-6965

NPI assigned

Feb 6, 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

Other names 1

• Mrs. Dianne Jackson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Medstop One Inc

  • Clinic/Center
  • Cape Girardeau, MO
  • NPI 1417959149
  NPD (past)

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1922070655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 JOHN R BLVD",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638012443",
            "telephone_number": "573-471-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 NEW JERSEY AVE",
            "city": "FORT DIX",
            "state": "NJ",
            "postal_code": "086405017",
            "telephone_number": "609-562-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DIANNE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "098462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANNE",
            "last_name": "JACKSON",
            "prefix": "MRS.",
            "credential": "FNP-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Michelle Denise Guy, LPN
• Vincent Depaul Hess, LPN
• Joy A Hoffman, PTA
• Bruce Wayne Holmes, PSY.D
• Joshua Evans Houseman, PSY.D.
• Marcia Annette Johnson, CRNP
• Keller Army Community Hospital
• Keller Army Community Hospital
• Kristin Klacik, MA LCDC
• Li Wei Lin

• All providers in Fort Dix, NJ
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.