Shauntorya Jackson, AGNP
NPI 1104296615 · Gerontology Nurse Practitioner · Flower Mound, TX
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Shauntorya Jackson, AGNP is a Gerontology Nurse Practitioner provider in Flower Mound, TX (NPI 1104296615).
Provider details
- NPI number
- 1104296615
- Entity type
- Individual
- Primary specialty
- Gerontology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- AGNP
- Sex
- Female
- Sole proprietor
- No
- License
- AP128145 (TX)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
10 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
2,519 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Subsequent Nursing Facility Care With Moderate Level of Medical Decision Making, Per Day, If Using Time, at Least 30 Minutes99309 | 1,817 | $89 |
| Residence Visit for Established Patient With Moderate Level of Medical Decision Making, Per Day, If Using Time, at Least 40 Minutes99349 | 192 | $108 |
| Subsequent Nursing Facility Care With High Level of Medical Decision Making, Per Day, If Using Time, at Least 45 Minutes99310 | 187 | $128 |
| Initial Or Subsequent Psychiatric Collaborative Care Management, First 30 Minutes in a Month of Behavioral Health Care Manager Activities, in Consultation With a Psychiatric Consultant, and Directed By the Treating Physician Or Other Qualified Health CareG2214 | 112 | $47 |
| Subsequent Nursing Facility Care With Moderate Level of Medical Decision Making, Per Day, If Using Time, at Least 30 Minutes99309 | 79 | $89 |
Practice location
Mailing address
Registry dates
- Enumerated
- 2015-09-28
- Last updated
- 2023-07-05
- Certified
- 2023-07-05
Frequently asked questions
- What is Shauntorya Jackson's NPI number?
- Shauntorya Jackson's National Provider Identifier (NPI) is 1104296615, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Shauntorya Jackson's specialty?
- Shauntorya Jackson is listed in the NPPES registry with a primary specialty of Gerontology Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Shauntorya Jackson located?
- Shauntorya Jackson's practice location on file with NPPES is 2281 Olympia Dr, Flower Mound, TX 75028-1857.
- What is Shauntorya Jackson's phone number?
- The practice phone number listed in the NPPES registry for Shauntorya Jackson is (469) 322-0089.
- Does Shauntorya Jackson accept Medicare?
- Shauntorya Jackson is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Shauntorya Jackson's NPI active?
- Yes — Shauntorya Jackson's NPI (1104296615) is active in the NPPES registry as of the last update on 2023-07-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.