Yolanda Jackson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1440 Hawn Ave
Shreveport, LA 71107-6532

Phone

(318) 226-5990

NPI assigned

Jan 12, 2022

Sex

Female

Sole proprietor

No

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

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• CBS Act Center LLC

  • Community/Behavioral Health Agency
  • Shreveport, LA
  • NPI 1396081097
  NPD (past)

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

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1003567009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 HAWN AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711076532",
            "telephone_number": "318-226-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 HAWN AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711076532",
            "telephone_number": "318-226-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "YOLANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-12",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Troy A Jackson
• Ungela Jackson
• Wanda Kay Jackson, RDH
• William Jackson
• Yasma Jackson
• Maureen McDonald Jacobs
• Steve Alton Jacobs, C.R.N.A.
• Tibb Marie Jacobs, PHARM.D.
• Richard Wesley Jacobson, MD
• Jacqueline a. Danzell, LCSW, LLC

• Case Manager/Care Coordinator in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.