Nicole Jackson, FNP, PMHNP - Medicare Nurse Practitioner in Dover, DE

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Nicole Jackson, FNP, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Dover, Delaware. She graduated from nursing school in 2017 and has 7 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice A Peaceful Place Integrated Care, Mid-atlantic Behavioral Health, Llc and her current practice location is 200 Banning St Ste 260, Dover, Delaware. You can reach out to her office (for appointments etc.) via phone at (302) 224-1400.

Nicole Jackson is licensed to practice in Delaware (license number L80010226) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1366974628.

Contact Information

Nicole Jackson, FNP, PMHNP
200 Banning St Ste 260,
Dover, DE 19904-3489
(302) 224-1400
(302) 224-1402

Map and Direction




Provider's Profile

Full NameNicole Jackson
GenderFemale
SpecialityNurse Practitioner
Experience7 Years
Location200 Banning St Ste 260, Dover, Delaware
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Nicole Jackson graduated from nursing school in 2017
  NPI Data:
  • NPI Number: 1366974628
  • Provider Enumeration Date: 03/28/2017
  • Last Update Date: 02/20/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 7113294034
  • Enrollment ID: I20170525000568

Medical Identifiers

Medical identifiers for Nicole Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1366974628NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner LG0001029 (Delaware)Secondary
363LF0000XNurse Practitioner - Family LG0001029 (Delaware)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health L80010226 (Delaware)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
A Peaceful Place Integrated Care13557427354
Mid-atlantic Behavioral Health, Llc337562001639

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Nicole Jackson allows following entities to bill medicare on her behalf.
Entity NameWestside Family Healthcare, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1952303695
PECOS PAC ID: 6800706599
Enrollment ID: O20040716000419
Entity NameMid-atlantic Behavioral Health, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1871719872
PECOS PAC ID: 3375620016
Enrollment ID: O20080407000009
Entity NameAnew Mental Health
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1780092528
PECOS PAC ID: 3870810229
Enrollment ID: O20150323001832
Entity NameA Peaceful Place Integrated Care
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1801487046
PECOS PAC ID: 1355742735
Enrollment ID: O20210622003821
Entity NameAmerican Treatment Network Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1871182451
PECOS PAC ID: 8820402993
Enrollment ID: O20211222000012
Entity NameAtn Physicians & Associates Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1275189375
PECOS PAC ID: 2769813708
Enrollment ID: O20220119001656
Entity NameGenesis Integrative Mental Health
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1598534711
PECOS PAC ID: 1951754449
Enrollment ID: O20240131004150

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicole Jackson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Nicole Jackson, FNP, PMHNP
200 Banning St Ste 260,
Dover, DE 19904-3489

Ph: (302) 224-1400		Nicole Jackson, FNP, PMHNP
200 Banning St Ste 260,
Dover, DE 19904-3489

Ph: (302) 224-1400

Reviews and Comments


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Linda Ann Ashley, CFNP
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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.