DR. LASTASHA R JACKSON (CRNP) – Family Nurse Practitioner, NPI 1356911325

DR. LASTASHA R JACKSON (CRNP) is a healthcare provider. based in Norristown, Pennsylvania. specializing in NURSE PRACTITIONER. They hold the professional credentials CRNP. They hold a License No. SP022131 (PA). The NPI Number for DR. LASTASHA R JACKSON (CRNP) is 1356911325

Main info

Female
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
DR. LASTASHA R JACKSON (CRNP)
NPI
1356911325
Phone
(484) 213-3591
Address
330 E BROWN ST
Enumeration Date
30 June 2021
Last Update Date
30 June 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7328866202
Graduation Year
2021 (5 years ago)
PAC ID
9931585577
Group Practice PAC ID
3678972130
Professional Enrollment ID
I20221004003973
Address ID
PA194033905NO1033XMEDI700
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

11,473 NURSE PRACTITIONER in PA

Provider Addresses for DR. LASTASHA R JACKSON (CRNP)

  • 330 E BROWN ST

    NORRISTOWN, PA 194015407

    Phone: (484) 213-3591

    Type: Mailing

  • 215 BULLENS LN

    WOODLYN, PA 190942001

    Phone: (484) 416-0769

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $23.

Total Amount is formed as General ($23) + Research ($0) + Ownership ($0) = $23.

Last reported payment date: 2024-02-20 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($23).

Total Amount

$23

General + Research + Ownership

Payments

1

Total payment records

General Amount

$23

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-20

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: 2022-10-04

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
I20221004003973INurse PractitionerPATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99203New patient office or other outpatient visit, 30-44 minutes4242$0
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes3429$0
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes1715$0
87811Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)1515$0
99213Established patient office or other outpatient visit, 20-29 minutes1414$0
View full utilization report →

Insurance plans in this area (ZIP 19401)

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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: 3678972130View full group profile
NameSpecialtyState
Internal MedicinePA
General SurgeryPA
Nurse PractitionerPA
Nurse PractitionerPA
Nurse PractitionerPA
Nurse PractitionerPA
Nurse PractitionerPA
Physician AssistantPA
Nurse PractitionerPA
Nurse PractitionerPA

Reviews

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Frequently asked questions

What number should I use to identify DR. LASTASHA R JACKSON (CRNP) for billing?
Administrative and clinical systems typically use NPI 1356911325 for DR. LASTASHA R JACKSON (CRNP).
Should I treat DR. LASTASHA R JACKSON (CRNP) as an active provider?
Patients and plans typically see DR. LASTASHA R JACKSON (CRNP) as active in the national extract.
What does the directory say DR. LASTASHA R JACKSON (CRNP) does?
Insurance directories may phrase it differently, but here DR. LASTASHA R JACKSON (CRNP) maps to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Which community is linked to DR. LASTASHA R JACKSON (CRNP)?
DR. LASTASHA R JACKSON (CRNP) shows a connection to Norristown, Pennsylvania in registry-derived data.
Who maintains DR. LASTASHA R JACKSON (CRNP)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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