ROBERT DALE JACKSON DNP, FNP-C
NPI 1881076230
Nurse Practitioner in Coeur D Alene, ID

Q: What is Robert Jackson's NPI number?

The NPI number for Robert Jackson is 1881076230. It was assigned to this individual provider in the NPPES registry on June 22, 2015.

Q: What is Robert 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 Robert Jackson was last updated on August 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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 June 22, 2015PECOS EnrolledAccepts Medicare Assignment

1090 W PARK PL, COEUR D ALENE, ID 83814(208) 415-0299(208) 625-2070 Get Directions Write a Review

NPPES record last updated: August 13, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 13, 2025, Jun 26, 2025, Aug 29, 2018 (3 updates tracked since 2018).

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About Robert Dale Jackson Dnp, Fnp-c NPPES

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

ROBERT DALE JACKSON DNP, FNP-C (NPI 1881076230) is an individual nurse practitioner in Coeur D Alene, Idaho, licensed in Idaho (74218) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS, is affiliated with Kootenai Health, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1881076230

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameROBERT DALE JACKSONCredential: DNP, FNP-C

Location Address1090 W PARK PLCoeur D Alene, ID 83814-2785

Mailing Address1090 W Park PlCoeur D Alene, ID 83814-2785 · (208) 415-0299 · Fax (208) 625-2070

Phone(208) 415-0299

Fax(208) 625-2070

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateJune 22, 2015

Last NPPES UpdateAugust 13, 20253 updates tracked since enumeration

NPPES CertifiedAugust 13, 2025

✔ NPI 1881076230 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 ID · 74218

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.

1090 W PARK PL, Coeur D Alene, ID 83814

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans.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

Robert Dale Jackson Dnp, Fnp-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 ID547761660

PECOS Enrollment IDI20250829003491

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Kootenai Health

Acute Care Hospitals · Coeur D'alene, ID

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number130049

Location2003 Kootenai Health WayCoeur D'alene, ID 83814 · Kootenai County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83814 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$93.26 typical visit price

range $16.68 – $130.93

Typical copayment $23.31 (range $4.17 – $32.73)

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.

DEBORAH MAGNUSON APRN

Nurse Practitioner (Pediatrics)