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NICHOLE ROSE JACKSON NP-C
NPI 1184988438
Nurse Practitioner in Fargo, ND

Active since July 02, 2012PECOS Enrolled
3175 SIENNA DR S, FARGO, ND 58104(701) 205-3088(701) 335-7808 Get Directions Write a Review

NPPES record last updated: September 23, 2016. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Nichole Rose Jackson Np-c NPPES

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

NICHOLE ROSE JACKSON NP-C (NPI 1184988438) is an individual nurse practitioner in Fargo, North Dakota, licensed in North Dakota (R31008) and active in the NPI registry since July 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1184988438
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameNICHOLE ROSE JACKSONCredential: NP-C
Location Address3175 SIENNA DR SFargo, ND 58104-8910
Mailing Address530 3rd St EWest Fargo, ND 58078-2711 · (701) 205-3088 · Fax (701) 335-7808
Phone(701) 205-3088
Fax(701) 335-7808
Sole ProprietorNo
Enumeration DateJuly 2, 2012
Last NPPES UpdateSeptember 23, 2016
✔ NPI 1184988438 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 ND · R31008
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.
3175 SIENNA DR S, Fargo, ND 58104
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Other Names 1

Former Name (1)Nichole Jackson

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nichole Rose Jackson Np-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 58104 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
$85.71 typical visit price
range $55.75 – $168.12
Typical copayment $21.42 (range $13.93 – $42.03)
Most-billed visit code 99203
Established Patient
$98.29 typical visit price
range $18.11 – $137.65
Typical copayment $24.57 (range $4.52 – $34.41)
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 2

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

SPENCER D BERRY MD
Family Medicine
3175 SIENNA DR S, 103
FARGO, ND 58104
Cass County (701) 205-3088
DR. KAMERON PETERS D.C.
Chiropractor
3175 SIENNA DR S, SUITE 105
FARGO, ND 58104
Cass County (218) 686-4694

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 Nichole Jackson's NPI number?

The NPI number for Nichole Jackson is 1184988438. It was assigned to this individual provider in the NPPES registry on July 2, 2012.

Where is Nichole Jackson located?

Nichole Jackson practices at 3175 Sienna Dr S, Fargo, ND 58104. The listed phone number is (701) 205-3088.

What is Nichole Jackson's specialty?

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

Is Nichole Jackson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Nichole Jackson was last updated on September 23, 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.