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NICOLE JANICE JACKSON MD
NPI 1902434780
Pediatrics - Pediatric Critical Care Medicine in Philadelphia, PA

Active since March 29, 2020
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104(800) 590-2160 Get Directions Write a Review

NPPES record last updated: June 7, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 7, 2026, Jul 27, 2023, Mar 29, 2020 (3 updates tracked since 2020).

About Nicole Janice Jackson Md NPPES

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

NICOLE JANICE JACKSON MD (NPI 1902434780) is an individual pediatric critical care medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD494588) and active in the NPI registry since March 2020. She maintains a secondary practice location in Indianapolis.

NPPES Registry Identity

NPI1902434780
Entity TypeIndividualFemale
Primary Taxonomy2080P0203X
Provider Legal NameNICOLE JANICE JACKSONCredential: MD
Location Address3401 CIVIC CENTER BLVDPhiladelphia, PA 19104-4319
Mailing AddressPo Box 778912Chicago, IL 60677-8912 · (317) 777-6435
Phone(800) 590-2160
Sole ProprietorNo
Enumeration DateMarch 29, 2020
Last NPPES UpdateJune 7, 20263 updates tracked since enumeration
NPPES CertifiedJune 7, 2026
✔ NPI 1902434780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0203X
Licenses✔ Licensed in PA · MD494588✔ Licensed in IN · 11022739A
Definition
A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Also ListedPediatricsTaxonomy 208000000X · License 01091554A (IN)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3401 CIVIC CENTER BLVD, Philadelphia, PA 19104
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Secondary Practice Location 1

Location 1705 Riley Hospital DrIndianapolis, IN 46202-5109 · Phone (317) 948-2700 · Fax (317) 948-2959

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

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.

AARON DORFMAN M.D.
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - CARDIOLOGY
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-4040
MS. NICOLE MARIE KOEPKE CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - EMERGENCY MED
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1944
DR. CASSANDRA ALYS LIGH MD
Surgery (Plastic and Reconstructive Surgery)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-2208
DR. PREETI SOI
Psychiatry & Neurology (Child & Adolescent Psychiatry)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-7555
ROSALIND USHER M.D.
Pediatrics (Developmental - Behavioral Pediatrics)
3401 CIVIC CENTER BLVD, DIVISION OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-6336
DR. MATTHEW DAVID SCHREIER MD
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
DR. TERRENCE CALDWELL JR. PHARMD
Pharmacist (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
ALYSSA STIEFEL CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Jackson's NPI number?

The NPI number for Nicole Jackson is 1902434780. It was assigned to this individual provider in the NPPES registry on March 29, 2020.

Where is Nicole Jackson located?

Nicole Jackson practices at 3401 Civic Center Blvd, Philadelphia, PA 19104. The listed phone number is (800) 590-2160.

What is Nicole Jackson's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

What insurance does Nicole Jackson accept?

Health plans from CareSource list Nicole Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Nicole Jackson was last updated on June 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.