MS. MARY KATHERINE JACKSON (FNP) – Family Nurse Practitioner, NPI 1780664854

MS. MARY KATHERINE JACKSON (FNP) is a healthcare provider. based in Orange park, Florida. specializing in Family Nurse Practitioner. They hold the professional credentials FNP. They hold a License No. 420469 (CA). The NPI Number for MS. MARY KATHERINE JACKSON (FNP) is 1780664854

Main info

Female
30 Years Of Experience
Accepts Medicare Assignment
Name
MS. MARY KATHERINE JACKSON (FNP)
NPI
1780664854
Phone
(904) 542-7516
Address
2521 SUNNY CREEK DR
Enumeration Date
17 January 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9042609699
Graduation Year
1996 (30 years ago)
PAC ID
8123352291
Group Practice PAC ID
0648177733
Professional Enrollment ID
I20190624001024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for MS. MARY KATHERINE JACKSON (FNP)

  • 2521 SUNNY CREEK DR

    ORANGE PARK, FL 320034970

    Phone: (904) 542-7516

    Fax: (904) 542-7913

    Type: Mailing

  • Naval Hospital Jacksonville, 2080, Child Street, Jacksonville, Duval County, Florida, 32214, United States

    JACKSONVILLE, FL 322145005

    Phone: (904) 542-7516

    Fax: (904) 542-7913

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 9 Open Payments records for all available years, with a total value of $12,893.

Total Amount is formed as General ($12,893) + Research ($0) + Ownership ($0) = $12,893.

Last reported payment date: 2024-11-25 • Largest payer in this snapshot: Medtronic, Inc. ($12,893).

Total Amount

$12,893

General + Research + Ownership

Payments

9

Total payment records

General Amount

$12,893

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-25

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Medtronic, Inc.$12,893
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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

No Medicare enrollment or revalidation data available for this provider in our database.

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 32003)

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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: 0648177733View full group profile
NameSpecialtyState
Family PracticeFL
H O S P I T A L I S TUT
Internal MedicineUT
-UT
Hospitalist, Internal MedicineVA
Internal MedicineFL
Internal MedicineGA
Family PracticeUT
Nurse PractitionerGA
Hospitalist, Internal MedicineFL

Reviews

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Frequently asked questions

What unique ID ties claims to MS. MARY KATHERINE JACKSON (FNP)?
NPI 1780664854 is assigned to MS. MARY KATHERINE JACKSON (FNP) under the national enumeration system.
Is MS. MARY KATHERINE JACKSON (FNP) active in the national directory?
MS. MARY KATHERINE JACKSON (FNP)'s public NPI profile is in an active state.
Does MS. MARY KATHERINE JACKSON (FNP) list a primary specialty?
If you are matching referrals, note Family Nurse Practitioner for MS. MARY KATHERINE JACKSON (FNP). Clinical services aligned with this taxonomy classification.
What location metadata exists for MS. MARY KATHERINE JACKSON (FNP)?
The page summarizes Orange Park, Florida for MS. MARY KATHERINE JACKSON (FNP); expand the address list for detail.
How can I contact MS. MARY KATHERINE JACKSON (FNP)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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