Ladaysha L Jackson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9361683 Issued in FL

Practice address

14 W Jordan St Ste 1J
Pensacola, FL 32501-1734

Phone

(850) 455-1252

Fax

(844) 683-8754

NPI assigned

Mar 8, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jdpremium Healthcare, LLCGroup PAC ID 6800100132, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ladaysha.jackson.1@34111.direct.athenahealth.com
• Direct secure messaging: ladaysha.jackson.1@30520.direct.athenahealth.com

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.

• Jdpremium Healthcare, LLC

  • Family Medicine Physician
  • Pensacola, FL
  • NPI 1538557608
  Medicare reassignment Care Compare group NPD Authorized official
• One Check Away Inc

  • Family Nurse Practitioner
  • Sarasota, FL
  • NPI 1831078211
  Medicare reassignment

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

{
    "created_epoch": "1362700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1962743351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 W JORDAN ST STE 1J",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011734",
            "telephone_number": "850-455-1252",
            "fax_number": "844-683-8754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 W JORDAN ST STE 1J",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011734",
            "telephone_number": "850-455-1252",
            "fax_number": "844-683-8754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LADAYSHA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-08",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R872968",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9361683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie B Jackson, APRN
• Jamie Crystal Jackson, M.D.
• Jennifer Reiss Jackson, OTR/L
• Karen Jackson, CRNP
• Kiara Lashantae Jackson, MSW
• Laticia Jackson, MPH
• Luke Perry Jackson
• Marcus S Jackson Sr.
• Miranda Loren Jackson, DNP
• Paige Roton Jackson, N.P.

• Family Nurse Practitioner in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.