EBONY ADELE JACKSON CRNP
NPI 1609693662
Nurse Practitioner - Psychiatric/Mental Health in Dover, DE

Q: What is Ebony Jackson's NPI number?

The NPI number for Ebony Jackson is 1609693662. It was assigned to this individual provider in the NPPES registry on September 23, 2024.

Q: What is Ebony Jackson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Ebony Jackson was last updated on September 23, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 23, 2024PECOS Enrolled

1198 S GOVERNORS AVE STE 201, DOVER, DE 19904(302) 382-8698(302) 269-3800 Get Directions Write a Review

NPPES record last updated: September 23, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Ebony Adele Jackson Crnp NPPES

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

EBONY ADELE JACKSON CRNP (NPI 1609693662) is an individual psychiatric/mental health provider in Dover, Delaware, licensed in Delaware (L8-0010677) and active in the NPI registry since September 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1609693662

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameEBONY ADELE JACKSONCredential: CRNP

Location Address1198 S GOVERNORS AVE STE 201Dover, DE 19904-6930

Mailing Address1198 S Governors Ave Ste 201Dover, DE 19904-6930 · (302) 382-8698 · Fax (302) 269-3800

Phone(302) 382-8698

Fax(302) 269-3800

Sole ProprietorYes

Enumeration DateSeptember 23, 2024

NPPES CertifiedSeptember 22, 2024

✔ NPI 1609693662 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 DE · L8-0010677

1198 S GOVERNORS AVE STE 201, Dover, DE 19904

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ebony Adele Jackson Crnp 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 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.

New Patient

$88.37 typical visit price

range $57.12 – $173.08

Typical copayment $22.09 (range $14.28 – $43.27)

Most-billed visit code 99203

Established Patient

$100.68 typical visit price

range $18.36 – $141.05

Typical copayment $25.17 (range $4.59 – $35.26)

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 12

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

ABIGAIL ESTABROOK LPCMH

Counselor (Professional)