SHAWNTELL JACKSON MSN,FNP-BC
NPI 1245703354
Nurse Practitioner - Family in Chicago, IL

Q: What is Shawntell Jackson's NPI number?

The NPI number for Shawntell Jackson is 1245703354. It was assigned to this individual provider in the NPPES registry on January 10, 2019.

Q: What is Shawntell Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Shawntell Jackson was last updated on October 31, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since January 10, 2019PECOS EnrolledAccepts Medicare Assignment

2535 SOUTH MARTIN LUTHER KING DRIVE, CHICAGO, IL 60616(312) 842-7117(312) 326-2102 Get Directions Write a Review

NPPES record last updated: October 31, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 31, 2022, Sep 15, 2020, Aug 14, 2020 and 1 more (4 updates tracked since 2019).

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About Shawntell Jackson Msn,fnp-bc NPPES

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

SHAWNTELL JACKSON MSN,FNP-BC (NPI 1245703354) is an individual family provider in Chicago, Illinois, licensed in Illinois (209.01833) and active in the NPI registry since January 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Tinley Park, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1245703354

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSHAWNTELL JACKSONCredential: MSN,FNP-BC

Location Address2535 SOUTH MARTIN LUTHER KING DRIVEChicago, IL 60616

Mailing Address29373 Network PlChicago, IL 60673-1293 · (847) 390-5900

Phone(312) 842-7117

Fax(312) 326-2102

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateJanuary 10, 2019

Last NPPES UpdateOctober 31, 20224 updates tracked since enumeration

NPPES CertifiedOctober 27, 2022

✔ NPI 1245703354 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in IL · 209.01833

2535 SOUTH MARTIN LUTHER KING DRIVE, Chicago, IL 60616

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Secondary Practice Location 1

Location 118210 LA GRANGE RD, STE 209TINLEY PARK, IL 60487-7728 · Phone (708) 473-7873

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shawntell Jackson Msn,fnp-bc 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.

PECOS PAC ID840622445

PECOS Enrollment IDI20191120002059

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.

Areas of Expertise CMS Part B claims 3

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

39 services34 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

17 services17 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428

This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60616 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

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

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 7

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

DR. NIKITA SHROFF RALPH MD

Family Medicine