MARY JANE JACKSON R.N., N.P.
NPI 1467663195
Nurse Practitioner in Charlottesville, VA

Q: What is Mary Jane Jackson's NPI number?

The NPI number for Mary Jane Jackson is 1467663195. It was assigned to this individual provider in the NPPES registry on May 24, 2007.

Q: What is Mary Jane Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Mary Jane Jackson was last updated on July 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 May 24, 2007PECOS Enrolled

1204 W MAIN ST, CHARLOTTESVILLE, VA 22903(434) 924-0123(434) 924-3300 Get Directions Write a Review

NPPES record last updated: July 29, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 29, 2021, Mar 4, 2021 (2 updates tracked since 2021).

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About Mary Jane Jackson R.n., N.p. NPPES

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

MARY JANE JACKSON R.N., N.P. (NPI 1467663195) is an individual nurse practitioner in Charlottesville, Virginia, licensed in Virginia (0024167194) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS and maintains a secondary practice location in Charlottesville.

NPPES Registry Identity

NPI1467663195

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMARY JANE JACKSONCredential: R.N., N.P.

Location Address1204 W MAIN STCharlottesville, VA 22903-2824

Mailing AddressPo Box 9007Charlottesville, VA 22906-9007

Phone(434) 924-0123

Fax(434) 924-3300

Sole ProprietorNo

Enumeration DateMay 24, 2007

Last NPPES UpdateJuly 29, 20212 updates tracked since enumeration

NPPES CertifiedJuly 29, 2021

✔ NPI 1467663195 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in VA · 0024167194

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

1204 W MAIN ST, Charlottesville, VA 22903

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Secondary Practice Location 1

Location 11215 Lee StCharlottesville, VA 22908-0001 · Phone (434) 924-2047

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Jane Jackson R.n., N.p. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 22903 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

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$99.13 typical visit price

range $18.07 – $138.91

Typical copayment $24.78 (range $4.51 – $34.72)

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.

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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.

HEATHER STEVENS SPADER MD

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