SIMONE JACKSON NP
NPI 1134644396
Nurse Practitioner - Family in Las Vegas, NV

Q: What is Simone Jackson's NPI number?

The NPI number for Simone Jackson is 1134644396. It was assigned to this individual provider in the NPPES registry on August 9, 2017. The provider is also known as Simone Jackson Fnp, Pmhnp.

Q: What is Simone 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 Simone Jackson was last updated on December 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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 09, 2017PECOS EnrolledAccepts Medicare Assignment

101 CONVENTION CENTER DR STE 900, LAS VEGAS, NV 89109(702) 355-8294 Get Directions Write a Review

NPPES record last updated: December 15, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 15, 2025, Apr 14, 2021, Apr 2, 2021 and 2 more (5 updates tracked since 2017).

On this page

About Simone Jackson Np NPPES

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

SIMONE JACKSON NP (NPI 1134644396) is an individual family provider in Las Vegas, Nevada, licensed in Nevada (APRN002716) and active in the NPI registry since August 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1134644396

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSIMONE JACKSONCredential: NP

Location Address101 CONVENTION CENTER DR STE 900Las Vegas, NV 89109-2039

Mailing Address9005 W Oquendo Rd Apt 3036Las Vegas, NV 89148-1524 · (901) 283-1975

Phone(702) 355-8294

Sole ProprietorYes

Medical School CMSOtherGraduated 2017

Enumeration DateAugust 9, 2017

Last NPPES UpdateDecember 15, 20255 updates tracked since enumeration

NPPES CertifiedDecember 15, 2025

✔ NPI 1134644396 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

Licenses✔ Licensed in NV · APRN002716✔ Licensed in TX · AP134295

Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X · License APRN002716 (NV)

101 CONVENTION CENTER DR STE 900, Las Vegas, NV 89109

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Other Names 1

Other Name (5)Simone Jackson Fnp, Pmhnp

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

Simone Jackson Np 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 ID8729345236

PECOS Enrollment IDI20171207001912

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

Jackson Psychiatric And Primary Care Services

Same address

Psychiatric/Mental Health

101 CONVENTION CENTER DR STE 900
Las Vegas, NV 89109

Reassigned Medicare billing, Nevada enrollment

NPI 1689251183 (702) 355-8294

Southern Nevada Adult Mental Health

4.1 mi

Adult Mental Health

6161 W CHARLESTON BLVD
Las Vegas, NV 89146

Reassigned Medicare billing, Nevada enrollment
Medicare enrollment name: State Of Nevada
143 clinicians in this Medicare group

NPI 1891756920 (702) 486-6000

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

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.

201 services78 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89109 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

$88.51 typical visit price

range $57.07 – $173.24

Typical copayment $22.12 (range $14.26 – $43.31)

Most-billed visit code 99203

Established Patient

$100.60 typical visit price

range $18.27 – $140.96

Typical copayment $25.15 (range $4.56 – $35.24)

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 4

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

KAHAK NV INC

Case Management

101 CONVENTION CENTER DR STE 900
LAS VEGAS, NV 89109

Clark County (301) 641-1514

JACKSON PSYCHIATRIC AND PRIMARY CARE SERVICES

Nurse Practitioner (Psychiatric/Mental Health)

101 CONVENTION CENTER DR STE 900
LAS VEGAS, NV 89109

Clark County (702) 355-8294

NU GRACE FAMILY CARE LLC

In Home Supportive Care

101 CONVENTION CENTER DR STE 900
LAS VEGAS, NV 89109

Clark County (844) 684-7223

MARVELOUS COUNSELING & THERAPY OF NEVADA, LLC

Case Manager/Care Coordinator

101 CONVENTION CENTER DR STE 900
LAS VEGAS, NV 89109

Clark County (832) 580-1588

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 Simone Jackson's NPI number?

The NPI number for Simone Jackson is 1134644396. It was assigned to this individual provider in the NPPES registry on August 9, 2017. The provider is also known as Simone Jackson Fnp, Pmhnp.

Where is Simone Jackson located?

Simone Jackson practices at 101 Convention Center Dr Ste 900, Las Vegas, NV 89109. The listed phone number is (702) 355-8294.

What is Simone Jackson's specialty?

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

Is Simone Jackson enrolled in Medicare?

Yes. Simone 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.

Which organizations bill Medicare for Simone Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Simone Jackson reassigns Medicare benefits to 2 organizations: Jackson Psychiatric And Primary Care Services (Las Vegas, NV) and Southern Nevada Adult Mental Health (Las Vegas, NV). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Simone Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Simone Jackson was last updated on December 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.