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MS. DANI KATHLEEN JACKSON PNP
NPI 1104563188
Nurse Practitioner - Pediatrics in Saint Louis, MO

Active since May 19, 2022PECOS EnrolledAccepts Medicare Assignment
1 CHILDRENS PL, DIV PED NEPHROLOGY, SAINT LOUIS, MO 63110(314) 454-6043(888) 463-6898 Get Directions Write a Review

NPPES record last updated: April 17, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 25, 2024, Apr 10, 2024, Sep 23, 2022 and 1 more (4 updates tracked since 2022).

About Ms. Dani Kathleen Jackson Pnp NPPES

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

MS. DANI KATHLEEN JACKSON PNP (NPI 1104563188) is an individual pediatrics provider in Saint Louis, Missouri, licensed in Missouri (2022005949) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1104563188
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameMS. DANI KATHLEEN JACKSONCredential: PNP
Location Address1 CHILDRENS PL, DIV PED NEPHROLOGYSaint Louis, MO 63110-1002
Mailing AddressPo Box 7412011Chicago, IL 60674-2011 · (314) 454-6043 · Fax (888) 463-6898
Phone(314) 454-6043
Fax(888) 463-6898
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateMay 19, 2022
Last NPPES UpdateApril 17, 20254 updates tracked since enumeration
NPPES CertifiedJune 17, 2022
✔ NPI 1104563188 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in MO · 2022005949
1 CHILDRENS PL, Saint Louis, MO 63110
Open in Google Maps ↗

Other Identifiers 1

Medicaid420111583MO

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Dani Kathleen Jackson Pnp 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 ID5890176762
PECOS Enrollment IDI20220724000037
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 63110 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
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
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.

ARIE BAKER MSW, LCSW
Social Worker (Clinical)
1 CHILDRENS PL, CAMPUS BOX 8116
SAINT LOUIS, MO 63110
St. Louis City (314) 747-6169
SUSAN CHEUNG WALSH AUD
Audiologist-Hearing Aid Fitter
1 CHILDRENS PL
SAINT LOUIS, MO 63110
St. Louis City (314) 454-4649
MS. JENNIFER MARIE JACOBI PNP
Nurse Practitioner (Pediatrics)
1 CHILDRENS PL, DEPT NEUROLOGICAL SURGERY, STE 4E
SAINT LOUIS, MO 63110
St. Louis City (314) 362-3577
MS. EMILY LINCOLN RN, NNP-BC
Nurse Practitioner (Neonatal, Critical Care)
1 CHILDRENS PL
SAINT LOUIS, MO 63110
St. Louis City (314) 454-6000
MS. MARISSA ROSE PEREZ-MAGNELLI PNP
Nurse Practitioner (Pediatrics)
1 CHILDRENS PL, DEPT NEUROLOGY, STE 2130
SAINT LOUIS, MO 63110
St. Louis City (314) 454-6120
DR. WILLIAM L RIVES MD
Hospitalist
1 CHILDRENS PL, DIV PED HOSPITALIST MED
SAINT LOUIS, MO 63110
St. Louis City (314) 454-2076
DR. PETER M KILBRIDGE MD
Pediatrics
1 CHILDRENS PL, SUITE C
SAINT LOUIS, MO 63110
St. Louis City (314) 454-2479
DR. JEFFREY MAGEE MD
Pediatrics (Pediatric Hematology-Oncology)
1 CHILDRENS PL, DIV PED HEMATOLOGY AND ONC, STE 9S
SAINT LOUIS, MO 63110
St. Louis City (314) 454-6018

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 Dani Jackson's NPI number?

The NPI number for Dani Jackson is 1104563188. It was assigned to this individual provider in the NPPES registry on May 19, 2022.

Where is Dani Jackson located?

Dani Jackson practices at 1 Childrens Pl Div Ped Nephrology, Saint Louis, MO 63110. The listed phone number is (314) 454-6043.

What is Dani Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Dani Jackson enrolled in Medicare?

Yes. Dani Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Dani Jackson was last updated on April 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.