AMANDA JACKSON CPNP
NPI 1205460045
Nurse Practitioner - Pediatrics in Nixa, MO

Active since March 02, 2020PECOS Enrolled
940 W MOUNT VERNON ST STE 220, NIXA, MO 65714(417) 724-5437 Get Directions Write a Review

NPPES record last updated: March 11, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 11, 2020, Mar 2, 2020 (2 updates tracked since 2020).

About Amanda Jackson Cpnp NPPES

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

AMANDA JACKSON CPNP (NPI 1205460045) is an individual pediatrics provider in Nixa, Missouri, licensed in Missouri (2020008008) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205460045
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameAMANDA JACKSONCredential: CPNP
Location Address940 W MOUNT VERNON ST STE 220Nixa, MO 65714-9613
Mailing Address940 W Mount Vernon St Ste 220Nixa, MO 65714-9613 · (417) 724-5437
Sole ProprietorNo
Enumeration DateMarch 2, 2020
Last NPPES UpdateMarch 11, 20202 updates tracked since enumeration
NPPES CertifiedMarch 11, 2020
NPI 1205460045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License Licensed in MO · 2020008008
Also ListedRegistered NurseTaxonomy 163W00000X · License 2011022742 (MO)
940 W MOUNT VERNON ST STE 220, Nixa, MO 65714

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Amanda Jackson Cpnp 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 65714 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
$81.64 typical visit price
range $52.28 – $161.24
Typical copayment $20.41 (range $13.07 – $40.31)
Most-billed visit code 99203
Established Patient
$93.24 typical visit price
range $16.30 – $131.05
Typical copayment $23.31 (range $4.07 – $32.76)
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

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

Pediatrics
940 W MOUNT VERNON ST STE 220
NIXA, MO 65714

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 Amanda Jackson's NPI number?

The NPI number for Amanda Jackson is 1205460045. It was assigned to this individual provider in the NPPES registry on March 2, 2020.

Where is Amanda Jackson located?

Amanda Jackson practices at 940 W Mount Vernon St Ste 220, Nixa, MO 65714. The listed phone number is (417) 724-5437.

What is Amanda Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Amanda Jackson enrolled in Medicare?

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

What insurance does Amanda Jackson accept?

Health plans from Medica and UnitedHealthcare list Amanda Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Amanda Jackson was last updated on March 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.