Active NPI
Marianne Jackson
- Midwife
- Las Vegas, NV
National Provider Identifier
1013386374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- Practice address
- 1613 Stonefield St
Las Vegas, NV 89144-5405 - Phone
- (702) 245-6290
- NPI assigned
- Sep 16, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 54302 | NV | |
| Midwife | 176B00000X | Primary |
Addresses
Primary practice location
1613 Stonefield St
Las Vegas, NV 89144-5405
Mailing address
1613 Stonefield St
Las Vegas, NV 89144-5405
Phone (702) 245-6290
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54302 | NV | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442361600000",
"number": "1013386374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1613 STONEFIELD ST",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891445405",
"telephone_number": "702-245-6290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1613 STONEFIELD ST",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891445405",
"telephone_number": "702-245-6290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "MARIANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-16",
"last_updated": "2015-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NV",
"license": "54302",
"primary": false
},
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.