Registry record
- NPI
- 1104296615
- Profession
- Nurse Practitioner (NP)
- Specialty
- Gerontology Nurse Practitioner (363LG0600X)
- Practice address
- 2281 Olympia Dr, Suite 100
Flower Mound, TX 75028 - Phone
- 4693220089
- In the registry since
- September 28, 2015
- Last NPPES update
- July 5, 2023
- Sole proprietor
- No
- License
- AP128145 (TX)
At this location
This location lists no other NP or PA providers in our current data.
In context
The NPI number of Shauntorya Jackson is 1104296615. They are a Gerontology Nurse Practitioner in Flower Mound, Texas.
Shauntorya Jackson is one of 3 Gerontology Nurse Practitioners in Flower Mound and one of 1,529 across Texas in our data.
The NPI has been in the federal registry for 10 years, since September 28, 2015.
Frequently asked questions
What is NPI 1104296615?
NPI 1104296615 is the 10-digit National Provider Identifier assigned to Shauntorya Jackson, a Gerontology Nurse Practitioner practicing in Flower Mound, Texas. The record has been in the NPPES registry since September 28, 2015.
How do I verify this provider?
Cross-check NPI 1104296615 in the official CMS registry at npiregistry.cms.hhs.gov, and confirm license AP128145 with the TX licensing board. You can also run the number through our free NPI validator to confirm its checksum.
Is this information current?
This profile reflects the June 2026 NPPES data file. NPPES lists the record's last update as July 5, 2023. We refresh our data each month when CMS publishes a new file.
Data: NPPES public registry, June 2026 file. Not medical advice. Verify independently before care or credentialing decisions. Errors in the source record can be corrected at nppes.cms.hhs.gov; see our corrections page.