KATRINA MARCIA JACKSON (CNM) – Advanced Practice Midwife, NPI 1548099757

KATRINA MARCIA JACKSON (CNM) is a healthcare provider. based in New london, Connecticut. specializing in CERTIFIED NURSE MIDWIFE (CNM). They hold the professional credentials CNM. They hold a License No. 576 (CT). The NPI Number for KATRINA MARCIA JACKSON (CNM) is 1548099757

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
KATRINA MARCIA JACKSON (CNM)
NPI
1548099757
Phone
(860) 441-0711
Address
365 Montauk Ave
Enumeration Date
29 July 2024
Last Update Date
29 July 2024

Doctor Profile

Medical School Name
YALE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
8604434148
Graduation Year
2024 (2 years ago)
PAC ID
2769913979
Group Practice PAC ID
1254233836
Professional Enrollment ID
I20240930000265
Address ID
CT063204952NE3XXXXCVXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

156 CERTIFIED NURSE MIDWIFE (CNM) in CT

Provider Addresses for KATRINA MARCIA JACKSON (CNM)

  • 365 Montauk Ave

    New London, CT 063204769

    Phone: (860) 441-0711

    Type: Location

  • 402 CENTER ST

    WEST HAVEN, CT 065164204

    Phone: (405) 464-8126

    Type: Mailing

  • 3 SHAWS CV STE 206

    NEW LONDON, CT 063204968

    Phone: (860) 443-4148

    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: 2024-09-30

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
I20240930000265ICertified Nurse Midwife (Cnm)CTTBD

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 06320)

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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: 1254233836View full group profile
NameSpecialtyState
Interventional Cardiology, Cardiovascular Disease (Cardiology)CT
-CT
-CT
Internal MedicineNJ
Hospitalist, Internal MedicineCT
-CT
-CT
Internal MedicineCT
Nurse PractitionerCT
Physician AssistantCT

Reviews

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Frequently asked questions

Can I verify KATRINA MARCIA JACKSON (CNM) with an NPI only?
You can start verification with NPI 1548099757 for KATRINA MARCIA JACKSON (CNM), then check state licensing separately.
Is KATRINA MARCIA JACKSON (CNM) still practicing?
KATRINA MARCIA JACKSON (CNM) is currently listed as active in the public NPI registry.
What taxonomy line describes KATRINA MARCIA JACKSON (CNM)?
For research purposes, treat KATRINA MARCIA JACKSON (CNM) as Advanced Practice Midwife in this dataset. Clinical services aligned with this taxonomy classification.
What area does KATRINA MARCIA JACKSON (CNM) serve?
KATRINA MARCIA JACKSON (CNM)'s listing highlights New London, Connecticut; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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