Shonta Jackson

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Practice address

8301 Pence Rd Apt B
Charlotte, NC 28215-4357

Phone

(803) 342-0553

NPI assigned

Nov 30, 2020

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

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.

• Reassurance Home Health Care

  • Home Health Aide
  • Charlotte, NC
  • NPI 1609469113
  NPD Authorized official

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1013511070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 PENCE RD APT B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282154357",
            "telephone_number": "803-342-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 PENCE RD APT B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282154357",
            "telephone_number": "803-342-0553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8301 Pence Rd Apt B",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282154357",
            "country_code": "US",
            "telephone_number": "803-342-0553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHONTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reginald Jackson
• Robert Jackson
• Rosemary Helen Jackson, PH.D.
• Shatamra Jackson, MSW
• Shelia Yvonne Jackson, LCSW-A
• Stephanie Lynn Jackson, DDS, MS
• Steven Howard Jackson, D.C.
• Tara Michele Jackson, MA, CCC-SLP
• Te'Essence Jackson
• Tiffany Jackson, FNP-C

• Home Health Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Home Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.