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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 Clinton, MS

Active since August 22, 2024PECOS EnrolledAccepts Medicare Assignment
604 HIGHWAY 80 W STE P-1, CLINTON, MS 39056(601) 589-4854(601) 893-7096 Get Directions Write a Review

NPPES record last updated: September 24, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 24, 2026, Jul 22, 2026, Sep 26, 2024 and 1 more (4 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 Clinton, 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 Address604 HIGHWAY 80 W STE P-1Clinton, MS 39056-4108
Mailing Address604 Highway 80 W Ste P-1Clinton, MS 39056-4108 · (601) 589-4854 · Fax (601) 893-7096
Phone(601) 589-4854
Fax(601) 893-7096
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateAugust 22, 2024
Last NPPES UpdateSeptember 24, 20264 updates tracked since enumeration
NPPES CertifiedSeptember 24, 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
604 HIGHWAY 80 W STE P-1, Clinton, MS 39056
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter Health and more.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

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Dominique Jackson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Jackson Mental Health Services, LLC
41 mi
Psychiatric/Mental Health
1035 COURTNEY RD
Hermanville, MS 39086
  • Reassigned Medicare billing, Mississippi enrollment
NPI 1144196940 (601) 448-9924
Yeates Consulting ,llc
137 mi
Community/Behavioral Health
104 BRICKERTON ST
Columbus, MS 39701
  • Reassigned Medicare billing, Mississippi enrollment
  • 8 clinicians in this Medicare group
NPI 1104235951 (662) 328-3110

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39056 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.

STRENGTH IN SEASON COUNSELING, LLC
Counselor (Mental Health)
604 HIGHWAY 80 W STE P-1
CLINTON, MS 39056
Hinds County (601) 202-1114

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 604 Highway 80 W Ste P-1, Clinton, MS 39056. The listed phone number is (601) 589-4854.

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.

Which organizations bill Medicare for Dominique Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dominique Jackson reassigns Medicare benefits to 2 organizations: Jackson Mental Health Services, LLC (Hermanville, MS) and Yeates Consulting ,llc (Columbus, MS). 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 Dominique Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dominique Jackson accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 5 other insurers 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 September 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 38 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.