DONNA LACHELLE JACKSON
NPI 1114531217
Nurse Practitioner in Tyler, TX

Q: What is Donna Jackson's NPI number?

The NPI number for Donna Jackson is 1114531217. It was assigned to this individual provider in the NPPES registry on September 4, 2020.

Q: What is Donna Jackson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Donna Jackson was last updated on March 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 September 04, 2020PECOS EnrolledAccepts Medicare Assignment

2990 N BROADWAY AVE, TYLER, TX 75702(903) 535-9041 Get Directions Write a Review

NPPES record last updated: March 27, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 5, 2022, Jan 19, 2022, May 21, 2021 and 1 more (4 updates tracked since 2020).

On this page

About Donna Lachelle Jackson NPPES

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

DONNA LACHELLE JACKSON (NPI 1114531217) is an individual nurse practitioner in Tyler, Texas, licensed in Texas (1032219) and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS, is affiliated with Christus Mother Frances Hospital, and maintains a secondary practice location in Lindale.

NPPES Registry Identity

NPI1114531217

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameDONNA LACHELLE JACKSON

Location Address2990 N BROADWAY AVETyler, TX 75702-2149

Mailing Address523 S Fannin AveTyler, TX 75702-8204 · (903) 535-9041

Phone(903) 535-9041

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateSeptember 4, 2020

Last NPPES UpdateMarch 27, 20244 updates tracked since enumeration

NPPES CertifiedMarch 27, 2024

✔ NPI 1114531217 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in TX · 1032219

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.

Also ListedRegistered Nurse · Continuing Education/Staff DevelopmentTaxonomy 163WC1600X · License 676887 (TX)

2990 N BROADWAY AVE, Tyler, TX 75702

Open in Google Maps ↗

Secondary Practice Location 1

Location 13203 S Main StLindale, TX 75771-7727 · Phone (903) 266-4000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, UnitedHealthcare.Insurance ›

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

Donna Lachelle Jackson 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 ID1355732546

PECOS Enrollment IDI20211223000112

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.

Areas of Expertise CMS Part B claims 3

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.

160 services143 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.

140 services122 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

14 services14 patients

Hospital Affiliations CMS Care Compare 2

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

Christus Mother Frances Hospital

Acute Care Hospitals · Tyler, TX

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450102

Location800 East DawsonTyler, TX 75701 · Smith County

Emergency services Birthing friendly

Christus Mother Frances Hospital Sulphur Springs

Acute Care Hospitals · Sulphur Springs, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450236

Location115 Airport RdSulphur Springs, TX 75482 · Hopkins County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75702 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

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

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 18

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

CAROLYN R RISINGER MD

Pediatrics