ALISIA JACKSON (APRN) – Family Nurse Practitioner, NPI 1104436146
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,343 NURSE PRACTITIONER in KY
Provider Addresses for ALISIA JACKSON (APRN)
16605 CHESTNUT GLEN PL
LOUISVILLE, KY 402456121
Phone: (502) 709-0430
Type: Mailing
9204 TAYLORSVILLE RD STE 217
LOUISVILLE, KY 402991789
Phone: (502) 709-0430
Type: Location
7122 BLUE STREAM CT
LOUISVILLE, KY 402584643
Phone: (502) 408-7347
Type: Mailing
4010 DUPONT CIR STE 226
LOUISVILLE, KY 402074847
Phone: (502) 377-7720
Type: Location
16605 Chestnut Glen Pl
Louisville, KY 402456121
Phone: (502) 709-0430
Type: Location
721 S PRESTON ST
LOUISVILLE, KY 402032319
Phone: (502) 583-1799
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $139.
Total Amount is formed as General ($139) + Research ($0) + Ownership ($0) = $139.
Last reported payment date: 2024-05-29 • Largest payer in this snapshot: ABBVIE INC. ($125).
Total Amount
$139
General + Research + Ownership
Payments
2
Total payment records
General Amount
$139
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $125 |
| Optinose US, Inc. | $14 |
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: 2021-02-11
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210211003499 | I | Nurse Practitioner | KY | TBD |
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.
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 40245)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | GA | |
| - | KY | |
| - | KY | |
| - | KY | |
| Nurse Practitioner | KY | |
| - | KY |
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