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

Dr. Nicole M. Jackson, MD

Individual provider Family Medicine Physician · NPI 1710364211

Dr. Nicole M. Jackson, MD is a Family Practice in Manchester, Connecticut. Graduated from Harvard Medical School in 2015, 11 years ago. Practices with Prospect CT Medical Foundation Inc, a 289-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Connecticut and Massachusetts.

Years since qualifying
11
Trained at
Harvard Medical School
Licensed in
CT, MA
In the registry since
2015
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

130 Hartford Rd
Manchester, CT 06040-5921
Phone: (860) 533-4673
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1 Boston Medical Ctr Pl, Boston, MA 02118-2908 — (617) 414-4465
  • 637 Washington St, Dorchester, MA 02124 — (617) 825-9660

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 66831 (CT)
Family Medicine Physician Taxonomy 207Q00000X · Licence 274945 (MA)

Record details

NPI number1710364211
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 4, 2015
Last updated in NPPESMay 13, 2026
Certification dateMay 13, 2026
Mailing address801 Albany St Fl G, Boston, MA 02119-3791

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolHARVARD MEDICAL SCHOOL
Graduated 2015 (11 years in practice)
Group practice Prospect Ct Medical Foundation Inc — 289 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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