MS. JERILYN ANN JACKSON R.D.
NPI 1306878079
Dietitian, Registered in Cranston, RI
About Ms. Jerilyn Ann Jackson R.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. JERILYN ANN JACKSON R.D. (NPI 1306878079) is an individual dietitian, registered in Cranston, Rhode Island, licensed in Rhode Island (LDN00388) and active in the NPI registry since July 2006. She maintains a secondary practice location in Pawtucket.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ms. Jerilyn Ann Jackson R.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jerilyn Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Cranston, RI 02920
- Reassigned Medicare billing, Rhode Island enrollment
- 45 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.
Other Providers at the Same Location NPPES 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Jerilyn Jackson's NPI number?
The NPI number for Jerilyn Jackson is 1306878079. It was assigned to this individual provider in the NPPES registry on July 6, 2006.
Where is Jerilyn Jackson located?
Jerilyn Jackson practices at 1170 Pontiac Ave, Cranston, RI 02920. The listed phone number is (401) 895-9937.
What is Jerilyn Jackson's specialty?
The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.
Is Jerilyn Jackson enrolled in Medicare?
Yes. Jerilyn Jackson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jerilyn Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jerilyn Jackson reassigns Medicare benefits to South County Psychiatry LLC (Cranston, RI). The 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 Jerilyn Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jerilyn Jackson was last updated on October 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days 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.
# Ms. Jerilyn Ann Jackson, R.D. · NPI 1306878079
Dietitian, Registered provider in Cranston, Rhode Island. Individual provider, active in the CMS NPPES registry since July 6, 2006.
## Identity
- **NPI:** 1306878079 (Entity type: Individual)
- **Enumerated:** July 6, 2006
- **Primary specialty:** Dietitian, Registered · taxonomy 133V00000X
- **State license:** LDN00388 (Rhode Island)
- **Sole proprietor:** No
## Practice location
- **Address:** 1170 PONTIAC AVE, Cranston, RI 02920-7944
- **Phone:** (401) 895-9937
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** South County Psychiatry LLC (NPI 1003454034, Cranston, RI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 29, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1306878079) · Data from the CMS NPPES public registry.