TANAGRA JACKSON FNP
NPI 1912620022
Nurse Practitioner in Nuevo, CA

Q: What is Tanagra Jackson's NPI number?

The NPI number for Tanagra Jackson is 1912620022. It was assigned to this individual provider in the NPPES registry on September 22, 2022.

Q: What is Tanagra 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 Tanagra Jackson was last updated on August 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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 September 22, 2022PECOS Enrolled

30427 DELTA DR, NUEVO, CA 92567(773) 530-5217 Get Directions Write a Review

NPPES record last updated: August 3, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 3, 2024, Sep 22, 2022 (2 updates tracked since 2022).

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About Tanagra Jackson Fnp NPPES

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

TANAGRA JACKSON FNP (NPI 1912620022) is an individual nurse practitioner in Nuevo, California, licensed in California (95021964) and active in the NPI registry since September 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912620022

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameTANAGRA JACKSONCredential: FNP

Location Address30427 DELTA DRNuevo, CA 92567-9470

Mailing Address30427 Delta DrNuevo, CA 92567-9470 · (773) 530-5217

Phone(773) 530-5217

Sole ProprietorNo

Enumeration DateSeptember 22, 2022

Last NPPES UpdateAugust 3, 20242 updates tracked since enumeration

NPPES CertifiedAugust 3, 2024

✔ NPI 1912620022 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in CA · 95021964

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.

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 95021964 (CA)

30427 DELTA DR, Nuevo, CA 92567

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tanagra Jackson Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 92567 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

$91.88 typical visit price

range $59.60 – $179.42

Typical copayment $22.97 (range $14.90 – $44.85)

Most-billed visit code 99203

Established Patient

$104.64 typical visit price

range $19.37 – $146.42

Typical copayment $26.16 (range $4.84 – $36.60)

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

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

ST AGNES NON-EMERGENCY MEDICAL TRANSPORTATION LLC

Transportation Network Company

30427 DELTA DR
NUEVO, CA 92567

Riverside County (562) 419-5050

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 Tanagra Jackson's NPI number?

The NPI number for Tanagra Jackson is 1912620022. It was assigned to this individual provider in the NPPES registry on September 22, 2022.

Where is Tanagra Jackson located?

Tanagra Jackson practices at 30427 Delta Dr, Nuevo, CA 92567. The listed phone number is (773) 530-5217.

What is Tanagra Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Tanagra Jackson enrolled in Medicare?

Yes. Tanagra Jackson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tanagra Jackson was last updated on August 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.