NPIMap

Organization Active NPI

Gloria Jackson

  • Skilled Nursing Facility
  • Lindenhurst, NY
National Provider Identifier
1013352079
Registry record updated May 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
252415-1 Issued in NY
Legal business name
GLORIA JACKSON
Practice address
525 S 9TH St
Lindenhurst, NY 11757-4529
Phone
(631) 226-3901
NPI assigned
May 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2013

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

Authorized official

Name
Gloria JacksonNPI 1356789713
Title
LPN
Phone
(631) 226-3901

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 252415-1 NY Primary

Addresses

Primary practice location

525 S 9TH St
Lindenhurst, NY 11757-4529

Mailing address

525 S 9TH St
Lindenhurst, NY 11757-4529
Phone (631) 226-3901

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367712000000",
    "number": "1013352079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 S 9TH ST",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117574529",
            "telephone_number": "631-226-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 S 9TH ST",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117574529",
            "telephone_number": "631-226-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLORIA JACKSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-05",
        "last_updated": "2013-05-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "LPN",
        "authorized_official_telephone_number": "631-226-3901"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "252415-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2013; 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.