REGINA RODGERS JACKSON FNP
NPI 1679076764
Nurse Practitioner - Family in Memphis, TN

Q: What is Regina Jackson's NPI number?

The NPI number for Regina Jackson is 1679076764. It was assigned to this individual provider in the NPPES registry on March 14, 2018.

Q: What is Regina Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Regina Jackson was last updated on April 28, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 14, 2018PECOS EnrolledAccepts Medicare Assignment

2861 BROAD AVE, MEMPHIS, TN 38112(901) 842-3161 Get Directions Write a Review

NPPES record last updated: April 28, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 16, 2018, Mar 14, 2018 (2 updates tracked since 2018).

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About Regina Rodgers Jackson Fnp NPPES

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

REGINA RODGERS JACKSON FNP (NPI 1679076764) is an individual family provider in Memphis, Tennessee, licensed in Mississippi (902247) and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1679076764

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameREGINA RODGERS JACKSONCredential: FNP

Location Address2861 BROAD AVEMemphis, TN 38112-2903

Mailing Address2861 Broad AveMemphis, TN 38112-2903 · (901) 842-3161

Phone(901) 842-3161

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateMarch 14, 2018

Last NPPES UpdateApril 28, 20232 updates tracked since enumeration

NPPES CertifiedApril 28, 2023

✔ NPI 1679076764 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MS · 902247

2861 BROAD AVE, Memphis, TN 38112

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health and more.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

Regina Rodgers Jackson Fnp 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 ID2769726793

PECOS Enrollment IDI20181203001655, I20230503001190

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 38112 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

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

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.

DR. ANDREW BUCHMAN NEARN M.D.

Pediatrics