1. Home
  2. Directory
  3. Utah
  4. Salt Lake City
  5. Nurse Practitioner
  6. NPI Profile

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

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: October 25, 2026.

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
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Vicki Jackman reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Utah Acuity Care Services
3.6 mi
Neurological Surgery
175 N MEDICAL DR
Salt Lake City, UT 84132
  • Reassigned Medicare billing, Utah enrollment
  • 338 clinicians in this Medicare group
NPI 1316341456 (801) 585-7575
University Of Utah Adult Services
3.6 mi
Neurology
175 N MEDICAL DR
Salt Lake City, UT 84132
  • Reassigned Medicare billing, Utah enrollment
  • 2,620 clinicians in this Medicare group
NPI 1578967345 (801) 585-7575

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.

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
Quality85.57
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 5

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

JARED B PROBST MD
Family Medicine
4624 HOLLADAY BLVD
SALT LAKE CITY, UT 84117
Salt Lake County (801) 277-2682
STEVEN W HEATH MD
Family Medicine
4624 HOLLADAY BLVD
SALT LAKE CITY, UT 84117
Salt Lake County (801) 277-2682
CHRISTOPHER J GAMBLE MD
Family Medicine
4624 HOLLADAY BLVD
SALT LAKE CITY, UT 84117
Salt Lake County (801) 277-2682
DR. JON T WALL MD
Family Medicine
4624 HOLLADAY BLVD
SALT LAKE CITY, UT 84117
Salt Lake County (801) 277-2682
DR. ROBERT J HILL JR. MD
Family Medicine
4624 HOLLADAY BLVD
SALT LAKE CITY, UT 84117
Salt Lake County (801) 277-2682

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 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.

Where is Vicki Jackman located?

Vicki Jackman practices at 4624 Holladay Blvd, Salt Lake City, UT 84117. The listed phone number is (801) 277-2682.

What is Vicki Jackman's specialty?

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

Is Vicki Jackman enrolled in Medicare?

Yes. Vicki Jackman is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Vicki Jackman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Vicki Jackman reassigns Medicare benefits to 2 organizations: University Of Utah Acuity Care Services (Salt Lake City, UT) and University Of Utah Adult Services (Salt Lake City, UT). 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 Vicki Jackman'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 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 5 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.