Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Colton Jackson, NP

Individual provider Family Nurse Practitioner · NPI 1942029152

Colton Jackson, NP is a Nurse Practitioner in Salem, Utah. Qualified in 2024, 2 years ago. Practices with Revere Health PC, a 410-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Utah.

Years since qualifying
2
Licensed in
UT
In the registry since
2024
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

555 W State Road 164
Salem, UT 84653-5732
Phone: (385) 203-2720
Fax: (801) 798-8961
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 9420231-4405 (UT)

Record details

NPI number1942029152
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedOctober 4, 2024
Last updated in NPPESOctober 4, 2024
Certification dateOctober 4, 2024
Mailing address1055 N 500 W, Attn: Credentialing, Provo, UT 84604

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Revere Health Pc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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