NICOLE JACKSON FNP, PMHNP
NPI 1366974628
Nurse Practitioner - Psychiatric/Mental Health in Dover, DE
About Nicole Jackson Fnp, Pmhnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NICOLE JACKSON FNP, PMHNP (NPI 1366974628) is an individual psychiatric/mental health provider in Dover, Delaware, licensed in Delaware (L80010226) and active in the NPI registry since March 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2017).
NPPES Registry Identity
Specialties & Licenses 3
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
Nicole Jackson Fnp, Pmhnp 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
5Medicare enrollment records show Nicole Jackson reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Dover, DE 19901
- Reassigned Medicare billing, Delaware enrollment
- 2 clinicians in this Medicare group
Dover, DE 19904
- Reassigned Medicare billing, Delaware enrollment
- 14 clinicians in this Medicare group
Dover, DE 19904
- Reassigned Medicare billing, Delaware enrollment
- 7 clinicians in this Medicare group
Newark, DE 19713
- Reassigned Medicare billing, Delaware enrollment
- 105 clinicians in this Medicare group
Newark, DE 19713
- Reassigned Medicare billing, Delaware enrollment
- 88 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 19904 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 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
DOVER, DE 19904
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 Nicole Jackson's NPI number?
The NPI number for Nicole Jackson is 1366974628. It was assigned to this individual provider in the NPPES registry on March 28, 2017.
Where is Nicole Jackson located?
Nicole Jackson practices at 200 Banning St Ste 260, Dover, DE 19904. The listed phone number is (302) 224-1400.
What is Nicole Jackson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Nicole Jackson enrolled in Medicare?
Yes. Nicole 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 Nicole Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Jackson reassigns Medicare benefits to 5 organizations: Genesis Integrative Mental Health (Dover, DE), Anew Mental Health (Dover, DE), A Peaceful Place Integrated Care (Dover, DE), Mid-Atlantic Behavioral Health, LLC (Newark, DE) and Westside Family Healthcare, Inc (Newark, DE). 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 Nicole Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Nicole Jackson accept?
Health plans from AmeriHealth Caritas Next list Nicole 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 Nicole Jackson was last updated on February 20, 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.
# Nicole Jackson, FNP, PMHNP · NPI 1366974628
Psychiatric/Mental Health physician in Dover, Delaware. Individual provider, active in the CMS NPPES registry since March 28, 2017.
## Identity
- **NPI:** 1366974628 (Entity type: Individual)
- **Enumerated:** March 28, 2017
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** L80010226 (Delaware)
- **Sole proprietor:** No
## Practice location
- **Address:** 200 BANNING ST STE 260, Dover, DE 19904-3489
- **Phone:** (302) 224-1400 · **Fax:** (302) 224-1402
## 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:** 5 organizations under Medicare reassignment (form CMS-855R): Genesis Integrative Mental Health (NPI 1598534711, Dover, DE); Anew Mental Health (NPI 1780092528, Dover, DE); A Peaceful Place Integrated Care (NPI 1801487046, Dover, DE); Mid-Atlantic Behavioral Health, LLC (NPI 1871719872, Newark, DE); Westside Family Healthcare, Inc (NPI 1801898556, Newark, DE) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** February 20, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1366974628) · Data from the CMS NPPES public registry.