Active NPI
Shameeka Kenyon Jackson
- Contractor
- Albany, GA
National Provider Identifier
1033649751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 2102 Oxford Rd
Albany, GA 31721-5215 - Phone
- (229) 296-5020
- NPI assigned
- Jun 14, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | GA | Primary |
Addresses
Primary practice location
2102 Oxford Rd
Albany, GA 31721-5215
Mailing address
2102 Oxford Rd
Albany, GA 31721-5215
Phone (229) 296-5020
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1033649751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2102 OXFORD RD",
"city": "ALBANY",
"state": "GA",
"postal_code": "317215215",
"telephone_number": "229-296-5020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2102 OXFORD RD",
"city": "ALBANY",
"state": "GA",
"postal_code": "317215215",
"telephone_number": "229-296-5020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "SHAMEEKA",
"middle_name": "KENYON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-14",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Contractor",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.