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

MS. Shavonne Jackson, NP

Individual provider Family Nurse Practitioner · NPI 1356052971

MS. Shavonne Jackson, NP is a Nurse Practitioner in Colonial Heights, Virginia. Qualified in 2022, 4 years ago. Practices with Pmr Virginia Holding LLC, a 19-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
4
Licensed in
VA
In the registry since
2022
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

524 Southpark Blvd
Colonial Heights, VA 23834-3609
Phone: (804) 504-7980
Fax: (804) 554-5387
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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 0024185612 (VA)

Record details

NPI number1356052971
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedDecember 6, 2022
Last updated in NPPESJuly 10, 2024
Certification dateJuly 10, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Pmr Virginia Holding Llc — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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