MARY TIFFANY JACKSON FNP
NPI 1811864655
Nurse Practitioner in Lynchburg, VA

Q: What is Mary Jackson's NPI number?

The NPI number for Mary Jackson is 1811864655. It was assigned to this individual provider in the NPPES registry on October 17, 2025. The provider is also known as Mary Tiffany Jackson.

Q: What is Mary 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 Jackson was last updated on January 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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 October 17, 2025PECOS EnrolledAccepts Medicare Assignment

1300 ENTERPRISE DR, LYNCHBURG, VA 24502(434) 845-6045 Get Directions Write a Review

NPPES record last updated: January 28, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 28, 2026, Nov 5, 2025 (2 updates tracked since 2025).

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About Mary Tiffany Jackson Fnp NPPES

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

MARY TIFFANY JACKSON FNP (NPI 1811864655) is an individual nurse practitioner in Lynchburg, Virginia, licensed in Virginia (0024195024) and active in the NPI registry since October 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1811864655

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMARY TIFFANY JACKSONCredential: FNP

Location Address1300 ENTERPRISE DRLynchburg, VA 24502-5746

Mailing Address4110 Ball Park LoopHalifax, VA 24558-2222 · (540) 312-5256

Phone(434) 845-6045

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateOctober 17, 2025

Last NPPES UpdateJanuary 28, 20262 updates tracked since enumeration

NPPES CertifiedJanuary 28, 2026

✔ NPI 1811864655 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 · 0024195024

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.

1300 ENTERPRISE DR, Lynchburg, VA 24502

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Other Names 1

Other Name (5)Mary Tiffany Jackson

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

Mary Tiffany 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 ID1557853397

PECOS Enrollment IDI20251119004477

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 24502 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 9

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

CENTRA HEALTH INC

Nursing Facility/Intermediate Care Facility