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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DOMINIQUE ALEXIS JACKSON PMHNP-C
NPI 1487487864
Nurse Practitioner - Psychiatric/Mental Health in Columbus, MS

Active since August 22, 2024PECOS EnrolledAccepts Medicare Assignment
470 WILKINS WISE RD, COLUMBUS, MS 39705(662) 570-1109 Get Directions Write a Review

NPPES record last updated: July 22, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 22, 2026, Sep 26, 2024, Aug 22, 2024 (3 updates tracked since 2024).

About Dominique Alexis Jackson Pmhnp-c NPPES

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

DOMINIQUE ALEXIS JACKSON PMHNP-C (NPI 1487487864) is an individual psychiatric/mental health provider in Columbus, Mississippi, licensed in Mississippi (906979) and active in the NPI registry since August 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1487487864
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameDOMINIQUE ALEXIS JACKSONCredential: PMHNP-C
Location Address470 WILKINS WISE RDColumbus, MS 39705-1780
Mailing Address1035 Courtney RdHermanville, MS 39086-7700 · (601) 589-4854 · Fax (601) 893-7096
Phone(662) 570-1109
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateAugust 22, 2024
Last NPPES UpdateJuly 22, 20263 updates tracked since enumeration
NPPES CertifiedJuly 22, 2026
✔ NPI 1487487864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in MS · 906979
470 WILKINS WISE RD, Columbus, MS 39705
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama.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

Dominique Alexis Jackson Pmhnp-c 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 ID941725063
PECOS Enrollment IDI20250421002767
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 39705 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
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
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

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

RONAK PARHI
Psychologist (Counseling)
470 WILKINS WISE RD
COLUMBUS, MS 39705
Lowndes County (662) 570-1109

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 Dominique Jackson's NPI number?

The NPI number for Dominique Jackson is 1487487864. It was assigned to this individual provider in the NPPES registry on August 22, 2024.

Where is Dominique Jackson located?

Dominique Jackson practices at 470 Wilkins Wise Rd, Columbus, MS 39705. The listed phone number is (662) 570-1109.

What is Dominique Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Dominique Jackson enrolled in Medicare?

Yes. Dominique 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 Dominique Jackson accept?

Health plans from Blue Cross and Blue Shield of Alabama list Dominique 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 Dominique Jackson was last updated on July 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 30 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.