Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1023720802 Individual Practitioner Male Practitioner

Nicholas Jackson

Specialist • Moorhead, MN

Professional Overview & Biography Verified Profile Summary

Nicholas Jackson is a registered healthcare professional specializing in Specialist in Moorhead, MN. Practice services are available at 1505 30TH AVE S under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1505 30th Ave S

Moorhead, MN 565605149

Telephone 2182874338
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Moorhead, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 34.7 Yrs
Regional Practice Density
182 Specialists

Practicing in Moorhead, MN (877 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-12-23
Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Janelle Smolen

Specialist

NPI 1003211855
Ashley Ramirez

Technician, Health Information

NPI 1003339417
NPI 1003432675
NPI 1003438128
Mckenzie Johnson

Behavior Analyst

NPI 1003462201
Kaci Longtin

Specialist

NPI 1003563925

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active December 23, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location December 23, 2022

Registered at 1505 30TH AVE S, MOORHEAD, MN 565605149 (Tel: 2182874338)

📍
Updated Business Mailing Address December 23, 2022

Registered at 1547 30TH AVE S, MOORHEAD, MN 565605149

👤
Provider Name / Credentials Updated December 23, 2022

Recorded as NICHOLAS JACKSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 23, 2022

Specialist

🟢
Initial NPI Registration & Enumeration December 23, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1023720802
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 23, 2022
Last Update: December 23, 2022
Sole Proprietor: No

Mailing Address

1547 30th Ave S

Moorhead, MN 565605149

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.