TIFFANY MICHELLE JACKSON APRN, AGNP-C
NPI 1114385374
Nurse Practitioner - Primary Care in Fayetteville, AR

Q: What is Tiffany Jackson's NPI number?

The NPI number for Tiffany Jackson is 1114385374. It was assigned to this individual provider in the NPPES registry on February 3, 2016.

Q: What is Tiffany Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Q: When was this NPI record last updated?

The NPPES record for Tiffany Jackson was last updated on August 5, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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 February 03, 2016PECOS Enrolled

12 E APPLEBY RD, SUITE 101, FAYETTEVILLE, AR 72703(479) 463-4444(479) 463-4499 Get Directions Write a Review

NPPES record last updated: August 5, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Tiffany Michelle Jackson Aprn, Agnp-c NPPES

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

TIFFANY MICHELLE JACKSON APRN, AGNP-C (NPI 1114385374) is an individual primary care provider in Fayetteville, Arkansas, licensed in Arkansas (A004646) and active in the NPI registry since February 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114385374

Entity TypeIndividualFemale

Primary Taxonomy363LP2300X

Provider Legal NameTIFFANY MICHELLE JACKSONCredential: APRN, AGNP-C

Location Address12 E APPLEBY RD, SUITE 101Fayetteville, AR 72703-3901

Mailing Address12 E Appleby Rd, Suite 101Fayetteville, AR 72703-3901 · (479) 463-4444 · Fax (479) 463-4499

Phone(479) 463-4444

Fax(479) 463-4499

Sole ProprietorNo

Enumeration DateFebruary 3, 2016

Last NPPES UpdateAugust 5, 2016

✔ NPI 1114385374 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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

Taxonomy Code363LP2300X

License✔ Licensed in AR · A004646

12 E APPLEBY RD, Fayetteville, AR 72703

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tiffany Michelle Jackson Aprn, Agnp-c 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 72703 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

$79.72 typical visit price

range $51.36 – $157.74

Typical copayment $19.93 (range $12.84 – $39.43)

Most-billed visit code 99203

Established Patient

$91.63 typical visit price

range $16.16 – $128.77

Typical copayment $22.90 (range $4.04 – $32.19)

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 16

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

EMILY J COOMBS APRN

Nurse Practitioner (Adult Health)

12 E APPLEBY RD, SUITE 101
FAYETTEVILLE, AR 72703

Washington County (479) 463-4444

WASHINGTON REGIONAL MEDICAL SYSTEM

Physical Therapist

12 E APPLEBY RD, SUITE 104
FAYETTEVILLE, AR 72703

Washington County (479) 463-6824

ANTOINETTE LYNN HARTMAN APN

Nurse Practitioner

12 E APPLEBY RD, STE 101
FAYETTEVILLE, AR 72703

Washington County (479) 463-4444

LAUREN HAYS

Speech-Language Pathologist

12 E APPLEBY RD, SUITE 104
FAYETTEVILLE, AR 72703

Washington County (479) 463-6824

CHELSEA RUSH THOMPSON AGPCNP-BC

Nurse Practitioner (Gerontology)

12 E APPLEBY RD
FAYETTEVILLE, AR 72703

Washington County (479) 463-4444

STEPHEN B GEMMELL PHD

Psychologist

12 E APPLEBY RD, STE 101
FAYETTEVILLE, AR 72703

Washington County (479) 463-4444

RANDY J SHINN MD

Internal Medicine (Geriatric Medicine)

12 E APPLEBY RD, STE 101
FAYETTEVILLE, AR 72703

Washington County (479) 463-4444

WASHINGTON REGIONAL MEDICAL CENTER

Dentist

12 E APPLEBY RD, SUITE 102
FAYETTEVILLE, AR 72703

Washington County (479) 463-4746

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 Tiffany Jackson's NPI number?

The NPI number for Tiffany Jackson is 1114385374. It was assigned to this individual provider in the NPPES registry on February 3, 2016.

Where is Tiffany Jackson located?

Tiffany Jackson practices at 12 E Appleby Rd Suite 101, Fayetteville, AR 72703. The listed phone number is (479) 463-4444.

What is Tiffany Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Tiffany Jackson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Tiffany Jackson was last updated on August 5, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.