JACKSONS HEALTH FAMILY HEALTH NP
NPI 1194494880
Clinic/Center - Primary Care in Rochester, NY
About Jacksons Health Family Health Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACKSONS HEALTH FAMILY HEALTH NP (NPI 1194494880) is a healthcare organization registered as a primary care in Rochester, New York and active in the NPI registry since September 2021. The organization holds a CLIA Waiver certificate valid through March 26, 2027, maintains a secondary practice location in Rochester, and lists Carnel Jackson, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jacksons Health Family Health Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
7Medicare enrollment records show 7 clinicians reassign Medicare billing to Jacksons Health Family Health Np, which bills Medicare for the services they deliver. Of these, 6 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (7)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 33D2258346
Jackson's Health - Family Health Np PLLC · Rochester, NYFrequently 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 Jacksons Health Family Health Np's NPI number?
The NPI number for Jacksons Health Family Health Np is 1194494880. It was assigned to this organization in the NPPES registry on September 7, 2021.
Where is Jacksons Health Family Health Np located?
Jacksons Health Family Health Np is located at 1655 Elmwood Ave Ste 125, Rochester, NY 14620. The listed phone number is (585) 340-6940.
What is Jacksons Health Family Health Np's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Jacksons Health Family Health Np enrolled in Medicare?
Yes. Jacksons Health Family Health Np is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Jacksons Health Family Health Np?
According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 2 Medicare specialties reassign their Medicare billing to Jacksons Health Family Health Np. A 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 the clinician's services. The largest specialties are Nurse Practitioner (5) and Mental Health Counselor (2). Of these, 6 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Jacksons Health Family Health Np hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 33D2258346) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Jacksons Health Family Health Np was last updated on September 8, 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.
# Jacksons Health Family Health Np · NPI 1194494880
Primary Care organization in Rochester, New York. Organization record, active in the CMS NPPES registry since September 7, 2021.
## Identity
- **NPI:** 1194494880 (Entity type: Organization)
- **Enumerated:** September 7, 2021
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Carnel Jackson, OWNER
## Practice location
- **Address:** 1655 ELMWOOD AVE STE 125, Rochester, NY 14620-3428
- **Phone:** (585) 340-6940
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 7 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (5), Mental Health Counselor (2); 6 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 8, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1194494880) · Data from the CMS NPPES public registry.