ALLIE JACKSON (NP) – Family Nurse Practitioner, NPI 1053983734

ALLIE JACKSON (NP) is a healthcare provider. based in Springfield, Missouri. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. F06211962 (MO). The NPI Number for ALLIE JACKSON (NP) is 1053983734

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
ALLIE JACKSON (NP)
NPI
1053983734
Phone
(417) 881-4994
Address
1435 E BRADFORD PKWY STE 105
Enumeration Date
13 July 2021
Last Update Date
13 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4178820035
Graduation Year
2021 (5 years ago)
PAC ID
8527457456
Group Practice PAC ID
4183047053
Professional Enrollment ID
I20211116000835
Address ID
MO658073480SP2800XAVEX405
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

7,017 NURSE PRACTITIONER in MO

Provider Addresses for ALLIE JACKSON (NP)

  • 1435 E BRADFORD PKWY STE 105

    SPRINGFIELD, MO 658046512

    Phone: (417) 881-4994

    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)

CMS reports 63 Open Payments records for all available years, with a total value of $1,235.

Total Amount is formed as General ($1,235) + Research ($0) + Ownership ($0) = $1,235.

Last reported payment date: 2024-11-12 • Largest payer in this snapshot: ABBVIE INC. ($477).

Total Amount

$1,235

General + Research + Ownership

Payments

63

Total payment records

General Amount

$1,235

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-12

Latest reported date

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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-11-16

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
I20211116000835INurse 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 65804)

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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: 4183047053View full group profile
NameSpecialtyState
Nurse PractitionerIL
Nurse PractitionerMO
Nurse PractitionerKS
Nurse PractitionerMO
Nurse PractitionerKS
Nurse PractitionerMO
Nurse PractitionerIL
Nurse PractitionerMO
Nurse PractitionerMO
Nurse PractitionerKS

Reviews

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Frequently asked questions

What identifier follows ALLIE JACKSON (NP) across health systems?
The NPI 1053983734 uniquely identifies ALLIE JACKSON (NP) in U.S. healthcare data.
Should I treat ALLIE JACKSON (NP) as an active provider?
Patients and plans typically see ALLIE JACKSON (NP) as active in the national extract.
Which specialty label fits ALLIE JACKSON (NP)?
NPPES ties ALLIE JACKSON (NP) to Family Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to ALLIE JACKSON (NP)?
ALLIE JACKSON (NP) shows a connection to Springfield, Missouri in registry-derived data.
Why is information missing for ALLIE JACKSON (NP)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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