RUTH A JACKSON NP
NPI 1821731746
Nurse Practitioner - Family in Warren, MI

Q: What is Ruth Jackson's NPI number?

The NPI number for Ruth Jackson is 1821731746. It was assigned to this individual provider in the NPPES registry on April 18, 2022. The provider is also known as Ruth A Flynn.

Q: What is Ruth 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 Ruth Jackson was last updated on April 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 April 18, 2022PECOS Enrolled

11800 E 12 MILE RD, WARREN, MI 48093(586) 576-4904(586) 573-5953 Get Directions Write a Review

NPPES record last updated: April 6, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 6, 2026, Apr 18, 2022 (2 updates tracked since 2022).

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About Ruth A Jackson Np NPPES

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

RUTH A JACKSON NP (NPI 1821731746) is an individual family provider in Warren, Michigan, licensed in Michigan (4704330240) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1821731746

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameRUTH A JACKSONCredential: NP

Location Address11800 E 12 MILE RDWarren, MI 48093-3472

Mailing Address47650 Barbara RdMacomb, MI 48044-2410 · (248) 259-1768

Phone(586) 576-4904

Fax(586) 573-5953

Sole ProprietorYes

Medical School CMSOtherGraduated 2021

Enumeration DateApril 18, 2022

Last NPPES UpdateApril 6, 20262 updates tracked since enumeration

NPPES CertifiedApril 6, 2026

✔ NPI 1821731746 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 MI · 4704330240

11800 E 12 MILE RD, Warren, MI 48093

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Other Names 1

Former Name (1)Ruth A Flynn

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ruth A Jackson Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4981179553

PECOS Enrollment IDI20260410002921

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 48093 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

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

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 20

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

DR. MICHEAL BUGGIA M.D.

Emergency Medicine