MRS. KRISTIE LYNN JACKSON (NP) – Family Nurse Practitioner, NPI 1053407817

MRS. KRISTIE LYNN JACKSON (NP) is a healthcare provider. based in Christiansburg, Virginia. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 0024167104 (VA). The NPI Number for MRS. KRISTIE LYNN JACKSON (NP) is 1053407817

Main info

Female
Sole Proprietor
20 Years Of Experience
Accepts Medicare Assignment
Name
MRS. KRISTIE LYNN JACKSON (NP)
NPI
1053407817
Phone
(540) 382-9139
Address
2900 MUDPIKE ROAD
Enumeration Date
5 October 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5409511111
Graduation Year
2006 (20 years ago)
PAC ID
3476724287
Group Practice PAC ID
4789932385
Professional Enrollment ID
I20110927000249
Address ID
VA240607017BL3700XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

8,303 NURSE PRACTITIONER in VA

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Provider Addresses for MRS. KRISTIE LYNN JACKSON (NP)

  • 2900 MUDPIKE ROAD

    CHRISTIANSBURG, VA 24073

    Phone: (540) 382-9139

    Type: Mailing

  • LewisGale Hospital Montgomery, 3700, South Main Street, Myers Acres, Blacksburg, Montgomery County, Virginia, 24060, United States

    BLACKSBURG, VA 24060

    Phone: (540) 953-5385

    Type: Location

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: 2011-09-27

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
I20110927000249INurse PractitionerVATBD

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
99285Emergency department visit with high level of medical decision making131129$0
99284Emergency department visit with moderate level of medical decision making4949$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only3837$0
View full utilization report →

Insurance plans in this area (ZIP 24073)

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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: 4789932385View full group profile
NameSpecialtyState
Emergency MedicineNY
Nurse PractitionerVA
Nurse PractitionerLA
Emergency MedicineSC
Sports MedicineMA
Emergency MedicineVA
Emergency MedicineVA
Emergency MedicineVA
Emergency MedicineTX
Emergency MedicineNC

Reviews

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Frequently asked questions

How do payers reference MRS. KRISTIE LYNN JACKSON (NP)?
For MRS. KRISTIE LYNN JACKSON (NP), use NPI 1053407817 as the unique 10-digit identifier.
Active or inactive — what applies to MRS. KRISTIE LYNN JACKSON (NP)?
You should see MRS. KRISTIE LYNN JACKSON (NP) as active in CMS-hosted NPPES data.
What clinical focus is listed for MRS. KRISTIE LYNN JACKSON (NP)?
At a glance, MRS. KRISTIE LYNN JACKSON (NP) is tied to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Virginia is MRS. KRISTIE LYNN JACKSON (NP) registered?
Use Christiansburg, Virginia as the headline location for MRS. KRISTIE LYNN JACKSON (NP) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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