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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SHELLY Y JACKSON RNC-FNP
NPI 1063491405
Nurse Practitioner in Poplar Bluff, MO

Active since January 13, 2006PECOS Enrolled
3001 WARRIOR LN STE A, POPLAR BLUFF, MO 63901(573) 778-7125(573) 778-7126 Get Directions Write a Review

NPPES record last updated: October 14, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Shelly Y Jackson Rnc-fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHELLY Y JACKSON RNC-FNP (NPI 1063491405) is an individual nurse practitioner in Poplar Bluff, Missouri, licensed in Missouri (126637) and active in the NPI registry since January 2006. She is enrolled in Medicare PECOS and maintains 26 additional practice locations.

NPPES Registry Identity

NPI1063491405
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameSHELLY Y JACKSONCredential: RNC-FNP
Location Address3001 WARRIOR LN STE APoplar Bluff, MO 63901-8685
Mailing Address110 S 2nd StEllington, MO 63638-9400 · (573) 663-2313 · Fax (573) 663-2441
Phone(573) 778-7125
Fax(573) 778-7126
Sole ProprietorNo
Enumeration DateJanuary 13, 2006
Last NPPES UpdateOctober 14, 2026
NPPES CertifiedOctober 12, 2026
✔ NPI 1063491405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in MO · 126637
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
3001 WARRIOR LN STE A, Poplar Bluff, MO 63901
Open in Google Maps ↗

Other Names 1

Former Name (1)Shelly Y Beardsley

Secondary Practice Locations 26

Location 111001 US-160Harviell, MO 63945 · Phone (573) 804-9561 · Fax (573) 804-9581
Location 21300 Victory LnPoplar Bluff, MO 63901-3300 · Phone (573) 785-5566 ext. 17097 · Fax (573) 413-4194
Location 3711 Nickey StPoplar Bluff, MO 63901-6544 · Phone (573) 785-7047 · Fax (573) 413-4192
Location 4109 Plum St Ste ADoniphan, MO 63935-1225 · Phone (573) 351-0150 · Fax (573) 996-2245
Location 5109 Plum St Ste CDoniphan, MO 63935-1225 · Phone (573) 351-0150
Location 6109 LeRoux StDoniphan, MO 63935-1038 · Phone (573) 996-2136 · Fax (573) 996-5216
Location 7405 Main StreetVan Buren, MO 63935 · Phone (573) 323-4253 · Fax (573) 323-0154
Location 8202 Allen StAnnapolis, MO 63620-8778 · Phone (573) 598-4213 · Fax (573) 598-1101
Location 92300 Baugh LnPoplar Bluff, MO 63901-2402 · Phone (573) 785-3037 · Fax (573) 413-4506
Location 10289 Broadway StNeelyville, MO 63954-7176 · Phone (573) 804-9494 · Fax (573) 804-9493
Location 11225 Physicians ParkPoplar Bluff, MO 63901-3935 · Phone (573) 727-5500 · Fax (573) 413-4609
Location 12225 Physicians Park Ste 102Poplar Bluff, MO 63901-3918 · Phone (573) 727-5500 ext. 2 · Fax (573) 413-4609
Location 1361 Highway YEllington, MO 63638-7802 · Phone (573) 663-2525 · Fax (573) 663-7844
Location 14225 Physicians Park Ste 104Poplar Bluff, MO 63901-3918 · Phone (573) 413-4065 · Fax (573) 354-5013
Location 15315 W Mulberry Ste APilot Knob, MO 63663-7883 · Phone (573) 546-0602 · Fax (573) 546-0546
Location 16603 E Summit StDoniphan, MO 63935-1142 · Phone (573) 996-3667 · Fax (573) 413-4487
Location 17225 Physicians Park Ste 200Poplar Bluff, MO 63901-3921 · Phone (573) 727-5500 ext. 5 · Fax (573) 313-3684
Location 18225 Physicians Park Ste 304Poplar Bluff, MO 63901-3930 · Phone (573) 727-5500 ext. 6 · Fax (573) 399-2646
Location 192879 James BlvdPoplar Bluff, MO 63901-3395 · Phone (573) 609-8800 · Fax (573) 776-6124
Location 2017959 Main StEminence, MO 65466-6375 · Phone (573) 226-5505 · Fax (573) 226-1256
Location 2118 Viburnum Center RdViburnum, MO 65566-7802 · Phone (573) 244-5406 · Fax (573) 244-5591
Location 22220 East Broad StreetNaylor, MO 63953 · Phone (573) 399-2311 · Fax (573) 399-2076
Location 23101 E Batten StreetNaylor, MO 63953 · Phone (573) 804-1779 · Fax (573) 804-1789
Location 241 Hals Plz Ste APiedmont, MO 63957-1631 · Phone (573) 223-4800 · Fax (573) 223-7911
Location 25109 Plum St Ste BDoniphan, MO 63935-1225 · Phone (573) 351-0220 · Fax (573) 996-2246
Location 263277 US Highway 160 WDoniphan, MO 63935-5710 · Phone (573) 804-9527 · Fax (573) 804-9536

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shelly Y Jackson Rnc-fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.64 typical visit price
range $52.28 – $161.24
Typical copayment $20.41 (range $13.07 – $40.31)
Most-billed visit code 99203
Established Patient
$93.24 typical visit price
range $16.30 – $131.05
Typical copayment $23.31 (range $4.07 – $32.76)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BIG SPRINGS MEDICAL ASSOCIATION
Clinic/Center (Federally Qualified Health Center (FQHC))
3001 WARRIOR LN STE A
POPLAR BLUFF, MO 63901
Butler County (573) 778-7125

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shelly Jackson's NPI number?

The NPI number for Shelly Jackson is 1063491405. It was assigned to this individual provider in the NPPES registry on January 13, 2006. The provider is also known as Shelly Y Beardsley.

Where is Shelly Jackson located?

Shelly Jackson practices at 3001 Warrior Ln Ste A, Poplar Bluff, MO 63901. The listed phone number is (573) 778-7125.

What is Shelly Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Shelly Jackson enrolled in Medicare?

Yes. Shelly Jackson is registered in the Medicare PECOS enrollment system.

What insurance does Shelly Jackson accept?

Health plans from Anthem Blue Cross and Blue Shield list Shelly Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shelly Jackson was last updated on October 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 31 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.