TIFFANY MICHELLE JACKSON FNP-C
NPI 1073161642
Nurse Practitioner - Family in Laurel Fork, VA

Q: What is Tiffany Jackson's NPI number?

The NPI number for Tiffany Jackson is 1073161642. It was assigned to this individual provider in the NPPES registry on August 27, 2019.

Q: What is Tiffany Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Tiffany Jackson was last updated on September 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.

Active since August 27, 2019PECOS EnrolledAccepts Medicare Assignment

14558 DANVILLE PIKE, LAUREL FORK, VA 24352(276) 398-2292(276) 398-3331 Get Directions Write a Review

NPPES record last updated: September 30, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 22, 2023, Aug 27, 2019 (2 updates tracked since 2019).

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About Tiffany Michelle Jackson Fnp-c NPPES

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

TIFFANY MICHELLE JACKSON FNP-C (NPI 1073161642) is an individual family provider in Laurel Fork, Virginia, licensed in Virginia (0024178133) and active in the NPI registry since August 2019. She is enrolled in Medicare PECOS, is affiliated with Twin County Regional Hospital, and maintains a secondary practice location in Hillsville.

NPPES Registry Identity

NPI1073161642

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameTIFFANY MICHELLE JACKSONCredential: FNP-C

Location Address14558 DANVILLE PIKELaurel Fork, VA 24352-3982

Mailing AddressPo Box 9Laurel Fork, VA 24352-0009 · (276) 398-1200

Phone(276) 398-2292

Fax(276) 398-3331

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateAugust 27, 2019

Last NPPES UpdateSeptember 30, 20252 updates tracked since enumeration

NPPES CertifiedSeptember 30, 2025

✔ NPI 1073161642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in VA · 0024178133

Also ListedRegistered NurseTaxonomy 163W00000X · License 0001197595 (VA)

14558 DANVILLE PIKE, Laurel Fork, VA 24352

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Secondary Practice Location 1

Location 1100 Cavs LnHillsville, VA 24343-1669 · Phone (888) 908-4788 · Fax (276) 398-3331

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tiffany Michelle Jackson Fnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8123438777

PECOS Enrollment IDI20210111001756

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.

Medicare Billing Reassignments

Medicare enrollment records show Tiffany Jackson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Tri Area Community Health

Same address

Federally Qualified Health Center (FQHC)

14558 DANVILLE PIKE
Laurel Fork, VA 24352

Reassigned Medicare billing, Virginia enrollment
43 clinicians in this Medicare group

NPI 1346227584 (276) 398-2292

Family Health Clinic, Inc.

29 mi

Family Medicine

600 RANDOLPH ST
Radford, VA 24141

Reassigned Medicare billing, Virginia enrollment
5 clinicians in this Medicare group

NPI 1740393891 (540) 639-5300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

28 services22 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

13 services13 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

11 services11 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Twin County Regional Hospital

Acute Care Hospitals · Galax, VA

2/5 CMS rating

OwnershipProprietary

CMS Certification Number490115

Location200 Hospital DriveGalax, VA 24333 · Galax City County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 24352 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

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$99.13 typical visit price

range $18.07 – $138.91

Typical copayment $24.78 (range $4.51 – $34.72)

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 20

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

ANNA W WRIGHT PSYD

Psychologist (Clinical)