KATINA JACKSON (APRN) – Family Nurse Practitioner, NPI 1942063714

KATINA JACKSON (APRN) is a healthcare provider. based in Claremore, Oklahoma. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 215992 (OK). The NPI Number for KATINA JACKSON (APRN) is 1942063714

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
KATINA JACKSON (APRN)
NPI
1942063714
Phone
(918) 341-8100
Address
206 E BLUE STARR DR
Enumeration Date
5 February 2024
Last Update Date
6 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9183418100
Graduation Year
2022 (4 years ago)
PAC ID
0648767228
Group Practice PAC ID
9032218029
Professional Enrollment ID
I20251016002484
Address ID
OK740174223CL206XXDRXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

3,299 NURSE PRACTITIONER in OK

Provider Addresses for KATINA JACKSON (APRN)

  • 206 E BLUE STARR DR

    CLAREMORE, OK 740174223

    Phone: (918) 341-8100

    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 2 Open Payments records for all available years, with a total value of $44.

Total Amount is formed as General ($44) + Research ($0) + Ownership ($0) = $44.

Last reported payment date: 2024-12-05 • Largest payer in this snapshot: Exact Sciences Corporation ($44).

Total Amount

$44

General + Research + Ownership

Payments

2

Total payment records

General Amount

$44

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-05

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2025-10-16

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
I20251016002484INurse PractitionerOKTBD

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 74017)

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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: 9032218029View full group profile
NameSpecialtyState
-OK
Emergency MedicineOK
Physician AssistantOK
Nurse PractitionerOK
Physician AssistantOK
Family PracticeOK

Reviews

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Frequently asked questions

Can I use this page to confirm KATINA JACKSON (APRN)'s NPI?
Yes. KATINA JACKSON (APRN) is listed with NPI 1942063714 in the public NPI dataset.
Does the file indicate KATINA JACKSON (APRN) is practicing under active NPI?
Directory data currently reports KATINA JACKSON (APRN) as active.
What taxonomy line describes KATINA JACKSON (APRN)?
For research purposes, treat KATINA JACKSON (APRN) as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What area does KATINA JACKSON (APRN) serve?
KATINA JACKSON (APRN)'s listing highlights Claremore, Oklahoma; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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