Individual provider Active NPI

Laura Jackson, DNP

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1962293969
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
222769 Issued in OK
Practice address
101 W Hefner Rd
Oklahoma City, OK 73114-6631
Phone
(405) 896-8058
Fax
(405) 417-4257
NPI assigned
May 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 222769 OK Primary

Addresses

Primary practice location

101 W Hefner Rd
Oklahoma City, OK 73114-6631

Mailing address

2 University PLZ Ste 204
Hackensack, NJ 07601-6211
Phone (551) 295-8223

Other practice location 1

3209 S Broadway Ste 229
Edmond, OK 73013-4064
Phone (551) 295-8223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20250522003353 OK Practitioner - Nurse Practitioner 1052830924 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ennoble HC NJ PCGroup PAC ID 0345638185, 129 clinicians

Practice addresses (Care Compare)

3209 S Broadway
Suite 229
Edmond, OK 73013-4064
Phone (551) 295-8223

Hospital & facility affiliations

  • Elara Caring XXV Home health agency, Tulsa, OK, CCN 377667
  • Complete Home Health of Western Oklahoma Home health agency, Enid, OK, CCN 377167
  • Angels Care Home Health of East Oklahoma Home health agency, Broken Arrow, OK, CCN 377171
  • Truheart Home Health Home health agency, Tulsa, OK, CCN 377615
  • Care Plus Home Health Care, Inc Home health agency, Tulsa, OK, CCN 377674

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ennoble HC NJ II PC CurrentSince Jul 30, 2025 Accepting new patients
Ennoble HC NJ PC CurrentSince May 19, 2025 Accepting new patients
Ennoble HC NJ III PC CurrentSince Jul 30, 2025 Accepting new patients

Locations

2 University Plz
Ste 204
Hackensack, NJ 07601
Phone (201) 564-0142

3209 S Broadway
Ste 229
Edmond, OK 73013
Phone 5512958223 ext. 58223

101 W Hefner Rd
Oklahoma City, OK 73114
Phone (405) 896-8058

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1747353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1962293969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 UNIVERSITY PLZ STE 204",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016211",
            "telephone_number": "551-295-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W HEFNER RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731146631",
            "telephone_number": "405-896-8058",
            "fax_number": "405-417-4257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3209 S Broadway Ste 229",
            "address_purpose": "LOCATION",
            "city": "Edmond",
            "state": "OK",
            "postal_code": "730134064",
            "country_code": "US",
            "telephone_number": "551-295-8223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LAURA",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-16",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "222769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.