CRYSTAL GAIL JACKSON (FNP) – Family Nurse Practitioner, NPI 1104786185

CRYSTAL GAIL JACKSON (FNP) is a healthcare provider. based in Rector, Arkansas. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 235288 (AR). The NPI Number for CRYSTAL GAIL JACKSON (FNP) is 1104786185

Main info

Female
Sole Proprietor
1 Year Of Experience
Accepts Medicare Assignment
Name
CRYSTAL GAIL JACKSON (FNP)
NPI
1104786185
Phone
(870) 634-6304
Address
PO BOX 331
Enumeration Date
13 November 2025
Last Update Date
16 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5737171072
Graduation Year
2025 (1 year ago)
PAC ID
4688166960
Group Practice PAC ID
5698773539
Professional Enrollment ID
I20251124003511
Address ID
MO638511617HA223XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness85
Years active:0State licenses:2Digital endpointsOther names

7,017 NURSE PRACTITIONER in MO

Provider Addresses for CRYSTAL GAIL JACKSON (FNP)

  • PO BOX 331

    RECTOR, AR 724610331

    Phone: (870) 634-6304

    Type: Mailing

  • 216 W MAIN ST

    STEELE, MO 638771436

    Phone: (573) 695-2181

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-11-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251124003511INurse PractitionerMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72461)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5698773539View full group profile
NameSpecialtyState
Nurse PractitionerMO
Nurse PractitionerMO
Nurse PractitionerMO
P O D I A T R YMO
Nurse PractitionerMO
Nurse PractitionerMO
Nurse PractitionerMO
Nurse PractitionerMO
Nurse PractitionerMO
Physician AssistantMO

Reviews

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Frequently asked questions

What unique ID ties claims to CRYSTAL GAIL JACKSON (FNP)?
NPI 1104786185 is assigned to CRYSTAL GAIL JACKSON (FNP) under the national enumeration system.
Is CRYSTAL GAIL JACKSON (FNP) currently active in the NPI registry?
CMS-published data lists CRYSTAL GAIL JACKSON (FNP) as an active registrant.
What field does CRYSTAL GAIL JACKSON (FNP) work in?
You can think of CRYSTAL GAIL JACKSON (FNP) as practicing within Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location shows for CRYSTAL GAIL JACKSON (FNP)?
We surface Rector, Arkansas for CRYSTAL GAIL JACKSON (FNP) based on available NPPES addresses.
What if Rector, Arkansas seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.