Active NPI
Jeanne Jackson, LPN
- Licensed Practical Nurse
- Wheat Ridge, CO
National Provider Identifier
1033327101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 42167
- Practice address
- 4803 Ward Rd
Wheat Ridge, CO 80033-1902 - Phone
- (303) 743-5855
- NPI assigned
- May 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 42167 | CO | Primary |
Addresses
Primary practice location
4803 Ward Rd
Wheat Ridge, CO 80033-1902
Mailing address
4662 Plettner LN
Evergreen, CO 80439-7300
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 |
|---|---|---|---|
| 42167 | CO | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194307200000",
"number": "1033327101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4662 PLETTNER LN",
"city": "EVERGREEN",
"state": "CO",
"postal_code": "804397300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4803 WARD RD",
"city": "WHEAT RIDGE",
"state": "CO",
"postal_code": "800331902",
"telephone_number": "303-743-5855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JEANNE",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-20",
"last_updated": "2007-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "CO",
"license": "42167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wheat Ridge, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.