VICKI L JACKMAN APRN
NPI 1154376077
Nurse Practitioner in Salt Lake City, UT

Q: What is Vicki Jackman's NPI number?

The NPI number for Vicki Jackman is 1154376077. It was assigned to this individual provider in the NPPES registry on May 23, 2006.

Q: What is Vicki Jackman'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 Vicki Jackman was last updated on October 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 May 23, 2006PECOS Enrolled

92.06/100

CMS Quality Rating

4624 HOLLADAY BLVD, SALT LAKE CITY, UT 84117(801) 277-2682(801) 277-2980 Get Directions Write a Review

NPPES record last updated: October 21, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Vicki L Jackman Aprn NPPES

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

VICKI L JACKMAN APRN (NPI 1154376077) is an individual nurse practitioner in Salt Lake City, Utah, licensed in Utah (295232-4405) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154376077

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameVICKI L JACKMANCredential: APRN

Location Address4624 HOLLADAY BLVDSalt Lake City, UT 84117-5206

Mailing Address4624 Holladay BlvdSalt Lake City, UT 84117-5206 · (801) 277-2682 · Fax (801) 277-2980

Phone(801) 277-2682

Fax(801) 277-2980

Sole ProprietorNo

Enumeration DateMay 23, 2006

Last NPPES UpdateOctober 21, 2021

NPPES CertifiedOctober 21, 2021

✔ NPI 1154376077 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in UT · 295232-4405

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.

4624 HOLLADAY BLVD, Salt Lake City, UT 84117

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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)

Vicki L Jackman Aprn 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.

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

20 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84117 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

$84.41 typical visit price

range $54.34 – $166.03

Typical copayment $21.10 (range $13.58 – $41.50)

Most-billed visit code 99203

Established Patient

$96.35 typical visit price

range $17.23 – $135.20

Typical copayment $24.08 (range $4.30 – $33.80)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.06/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

85.57

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 7

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

JARED B PROBST MD

Family Medicine