MRS. JULIE A JACKSON (ARNP) – Nurse Practitioner, NPI 1790775526

MRS. JULIE A JACKSON (ARNP) is a healthcare provider. based in Harlan, Kentucky. specializing in Nurse Practitioner. They hold the professional credentials ARNP. They hold a License No. 4452P (KY). The NPI Number for MRS. JULIE A JACKSON (ARNP) is 1790775526

Main info

Female
22 Years Of Experience
Accepts Medicare Assignment
Name
MRS. JULIE A JACKSON (ARNP)
NPI
1790775526
Phone
(606) 574-8409
Address
37 BALL PARK RD
Enumeration Date
24 October 2005
Last Update Date
22 July 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2004 (22 years ago)
PAC ID
3375572654
Group Practice PAC ID
0840107835
Professional Enrollment ID
I20050808000078
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 MRS. JULIE A JACKSON (ARNP)

  • Ball Park Road, Harlan County, Kentucky, 40855, United States

    HARLAN, KY 408311701

    Phone: (606) 574-8409

    Mailing address matches the actual address.

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: 2005-08-08

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
I20050808000078INurse PractitionerKYTBD

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 40831)

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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: 0840107835View full group profile
NameSpecialtyState
-WV
General SurgeryMN
Physician AssistantWV
-KY
Diagnostic RadiologyWV
Interventional CardiologyMD
Cardiovascular Disease (Cardiology), Cardiac ElectrophysiologyOH
Endocrinology, Internal MedicineNY
Orthopedic SurgeryMS
Nurse PractitionerKY

Reviews

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Frequently asked questions

Does MRS. JULIE A JACKSON (ARNP) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MRS. JULIE A JACKSON (ARNP) uses 1790775526.
Is MRS. JULIE A JACKSON (ARNP) listed as active for patients and plans?
The listing shows MRS. JULIE A JACKSON (ARNP) as active in the NPI system.
What is MRS. JULIE A JACKSON (ARNP) best known for clinically?
Directory data describes MRS. JULIE A JACKSON (ARNP) with Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does MRS. JULIE A JACKSON (ARNP) list a practice location?
Patients near Harlan, Kentucky may find MRS. JULIE A JACKSON (ARNP) in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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