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ANTONIA JACKSON
NPI 1356763593
Nurse Practitioner - Family in Trotwood, OH

Active since January 07, 2014PECOS EnrolledAccepts Medicare Assignment
5130 SALEM AVE, TROTWOOD, OH 45426(937) 529-4443 Get Directions Write a Review

NPPES record last updated: February 23, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 14, 2025, Feb 23, 2023, Oct 27, 2022 and 2 more (5 updates tracked since 2022).

About Antonia Jackson NPPES

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

ANTONIA JACKSON (NPI 1356763593) is an individual family provider in Trotwood, Ohio, licensed in Ohio (APRN.CNP.0030393) and active in the NPI registry since January 2014. She is enrolled in Medicare PECOS, maintains a secondary practice location in Midvale, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1356763593
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameANTONIA JACKSON
Location Address5130 SALEM AVETrotwood, OH 45426-2042
Mailing Address5130 Salem AveTrotwood, OH 45426-2042 · (937) 529-4443
Phone(937) 529-4443
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateJanuary 7, 2014
Last NPPES UpdateFebruary 23, 20235 updates tracked since enumeration
NPPES CertifiedFebruary 23, 2023
✔ NPI 1356763593 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in OH · APRN.CNP.0030393
Also ListedRegistered NurseTaxonomy 163W00000X · License 398426 (OH)
5130 SALEM AVE, Trotwood, OH 45426
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Secondary Practice Location 1

Location 17259 S Bingham Junction BlvdMidvale, UT 84047-4860 · Phone (800) 453-3030

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

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

Antonia 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.

PECOS PAC ID3779975842
PECOS Enrollment IDI20220121002409
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 45426 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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 4

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

RENA FRANCES RIVAS LOREK
Nurse Practitioner (Family)
5130 SALEM AVE
TROTWOOD, OH 45426
Montgomery County (937) 529-4443
SARAH AWWAD APRN
Nurse Practitioner (Family)
5130 SALEM AVE
TROTWOOD, OH 45426
Montgomery County (937) 529-4443
JENNY VICTORIA WARIBOKO MD
Internal Medicine
5130 SALEM AVE
TROTWOOD, OH 45426
Montgomery County (937) 529-4443
FIRST PRIORITY URGENT CARE LLC
Clinic/Center (Urgent Care)
5130 SALEM AVE
TROTWOOD, OH 45426
Montgomery County (305) 528-6689

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 Antonia Jackson's NPI number?

The NPI number for Antonia Jackson is 1356763593. It was assigned to this individual provider in the NPPES registry on January 7, 2014.

Where is Antonia Jackson located?

Antonia Jackson practices at 5130 Salem Ave, Trotwood, OH 45426. The listed phone number is (937) 529-4443.

What is Antonia Jackson's specialty?

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

Is Antonia Jackson enrolled in Medicare?

Yes. Antonia 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.

What insurance does Antonia Jackson accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Antidote Health Plan of Ohio, Inc. and 1 other insurer list Antonia 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 Antonia Jackson was last updated on February 23, 2023. 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.