Johnathan Stephen Jackson, DNP, FNP-C, PMHNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP130946 Issued in TX

Practice address

4100 Spring Valley Rd Ste 910
Farmers Branch, TX 75244-3646

Phone

(469) 474-5397

NPI assigned

May 5, 2016

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: optimumantiagingandwellness.johnathanjackson@151459.advancedmd-direct.com

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

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1992151104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 SPRING VALLEY RD STE 910",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752443646",
            "telephone_number": "940-290-7592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 SPRING VALLEY RD STE 910",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752443646",
            "telephone_number": "469-474-5397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JOHNATHAN",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C, PMHNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-05",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP130946",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP130946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Infusionmed USA Farmers Branch PLLC
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• Jack D. Seidel, M.D., P.a.
• Alicia Jackson, D.C.
• Kylie-Marie Jackson
• Jacob Joseph and Jabez Family Counseling and Professional Services Gro
• Choudary L Jagarlamudi
• JCB Home Health Care Inc
• JCSD Emergency Medical Group Inc

• Family Nurse Practitioner in Farmers Branch, TX
• Providers in Farmers Branch, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.