CATHERINE ALISA JACKSON
NPI 1215612031
Nurse Practitioner - Gerontology in Kettering, OH
About Catherine Alisa Jackson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CATHERINE ALISA JACKSON (NPI 1215612031) is an individual gerontology provider in Kettering, Ohio, licensed in Ohio (APRN.CNP.0034084) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS, is affiliated with Miami Valley Hospital, and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Catherine Alisa Jackson is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
4Medicare enrollment records show Catherine Jackson reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Miamisburg, OH 45342
- Reassigned Medicare billing, Ohio enrollment
- 984 clinicians in this Medicare group
Dayton, OH 45458
- Reassigned Medicare billing, Ohio enrollment
- 12 clinicians in this Medicare group
Toledo, OH 43606
- Reassigned Medicare billing, Ohio enrollment
- 36 clinicians in this Medicare group
Parma, OH 44129
- Reassigned Medicare billing, Ohio enrollment
- 56 clinicians in this Medicare group
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 2
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Miami Valley Hospital
Acute Care Hospitals · Dayton, OHPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 45429 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
KETTERING, OH 45429
KETTERING, OH 45429
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 Catherine Jackson's NPI number?
The NPI number for Catherine Jackson is 1215612031. It was assigned to this individual provider in the NPPES registry on June 19, 2023.
Where is Catherine Jackson located?
Catherine Jackson practices at 3535 Southern Blvd, Kettering, OH 45429. The listed phone number is (937) 298-4331.
What is Catherine Jackson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.
Is Catherine Jackson enrolled in Medicare?
Yes. Catherine Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Catherine Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Catherine Jackson reassigns Medicare benefits to 4 organizations: Kettering Independent Medical Group Inc (Miamisburg, OH), Namchi Le MD LLC (Dayton, OH), Caremed Ohio LLC (Toledo, OH) and Wound Care Consultants LLC (Parma, OH). 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 Catherine Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Catherine Jackson accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 1 other insurer list Catherine 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.
Is Catherine Jackson affiliated with any hospitals?
According to CMS data, Catherine Jackson is affiliated with Miami Valley Hospital.
When was this NPI record last updated?
The NPPES record for Catherine Jackson was last updated on January 25, 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.
# Catherine Alisa Jackson · NPI 1215612031
Gerontology physician in Kettering, Ohio. Individual provider, active in the CMS NPPES registry since June 19, 2023.
## Identity
- **NPI:** 1215612031 (Entity type: Individual)
- **Enumerated:** June 19, 2023
- **Primary specialty:** Nurse Practitioner - Gerontology · taxonomy 363LG0600X
- **State license:** APRN.CNP.0034084 (Ohio)
- **Sole proprietor:** No
## Practice location
- **Address:** 3535 SOUTHERN BLVD, Kettering, OH 45429-1221
- **Phone:** (937) 298-4331
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Kettering Independent Medical Group Inc (NPI 1629387865, Miamisburg, OH); Namchi Le MD LLC (NPI 1518486653, Dayton, OH); Caremed Ohio LLC (NPI 1669123949, Toledo, OH); Wound Care Consultants LLC (NPI 1831495373, Parma, OH) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** January 25, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1215612031) · Data from the CMS NPPES public registry.