Renee Camille Jackson, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-18-31297 Issued in TN

Practice address

6515 Holt Rd
Nashville, TN 37211-6903

Phone

(615) 832-0059

NPI assigned

Jul 12, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1003392028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4716 VENITO ST",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371224590",
            "telephone_number": "678-201-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6515 HOLT RD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372116903",
            "telephone_number": "615-832-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "RENEE",
        "middle_name": "CAMILLE",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "TN",
            "license": "1-18-31297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marisha Jackson
• Martisia Jackson, PHARM D
• Mary Elizabeth Jackson, P.T.
• Noelle Morgan Jackson
• Peyton Spies Jackson, APRN
• Robert Boyd Jackson IV, LCSW
• Samuel S Jackson III, D.D.S.
• Sandra Jackson, APRN
• Sharon Ann Jackson, MD
• Starr Unique Jackson, AU.D.

• Behavior Analyst in Nashville, TN
• Providers in Nashville, TN by specialty
• Behavior Analyst in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.