NICOLE JACKSON – Psychiatric/Mental Health Nurse Practitioner, NPI 1043753403
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
14,984 NURSE PRACTITIONER in OH
Provider Addresses for NICOLE JACKSON
16 W LONG ST
COLUMBUS, OH 432152815
Phone: (614) 225-0990
Type: Mailing
8483 TORWOODLEE CT # 8483
DUBLIN, OH 430179739
Phone: (614) 203-8546
Type: Mailing
4646 HILTON CORPORATE DR
COLUMBUS, OH 432324147
Phone: (614) 914-4541
Fax: (614) 866-8580
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $106.
Total Amount is formed as General ($106) + Research ($0) + Ownership ($0) = $106.
Last reported payment date: 2024-06-27 • Largest payer in this snapshot: Indivior Inc. ($87).
Total Amount
$106
General + Research + Ownership
Payments
5
Total payment records
General Amount
$106
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-27
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Indivior Inc. | $87 |
| Teva Pharmaceuticals USA, Inc. | $19 |
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: 2017-03-03
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 |
|---|---|---|---|---|
| I20170303000351 | I | Nurse Practitioner | OH | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 161 | 72 | $0 |
| Q3014 | Telehealth originating site facility fee | 126 | 58 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 13 | 12 | $0 |
Insurance plans in this area (ZIP 43215)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OH | |
| P S Y C H I A T R Y | OH | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.