Ursula L Jackson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP-019895 Issued in OH

Practice address

13944 Euclid Ave
East Cleveland, OH 44112-3804

Phone

(216) 767-4274

NPI assigned

Sep 16, 2016

Last updated

Feb 5, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ursula L Tellis Former name

Medicare fee-for-service enrollment

Enrolled in OH

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
• Euclid Hospital Hospital, Euclid, OH, CCN 360082

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Medicare reassignment Care Compare group NPD

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

• Cleveland Clinic Health System - East Region

  dba Euclid Hospital

  • General Acute Care Hospital
  • Euclid, OH
  • NPI 1598719346
  Care Compare affiliation
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation

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

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517788800000",
    "number": "1942758032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13944 EUCLID AVE",
            "city": "EAST CLEVELAND",
            "state": "OH",
            "postal_code": "441123804",
            "telephone_number": "216-767-4274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13944 EUCLID AVE",
            "city": "EAST CLEVELAND",
            "state": "OH",
            "postal_code": "441123804",
            "telephone_number": "216-767-4274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "URSULA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-16",
        "last_updated": "2018-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "CNP-019895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "URSULA",
            "last_name": "TELLIS",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Innovative Health Specialists
• Felicia Jenice Irby, STNA
• Beatrice Jackson
• Frances Marie Jackson, C.N.M.
• Taniesha M Jackson
• Garnell Jamison
• Jack Janosik, PHARMD
• Danica Nicole Johnson-Perkins
• Dwayne Johnson
• Joy Shamika Johnson, LPN

• Family Nurse Practitioner in East Cleveland, OH
• Providers in East Cleveland, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; 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.