Antoinette S Jackson

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

License

1404123254 Issued in NV

Practice address

5000 W Oakey Blvd Ste A3-4
Las Vegas, NV 89146-0391

Phone

(702) 377-1198

NPI assigned

Dec 19, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Ufcs LLC

  • Community/Behavioral Health Agency
  • North Las Vegas, NV
  • NPI 1639507452
  NPD (past)

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1043556087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3840 N COMMERCE ST",
            "address_2": "SUITE 100",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890328104",
            "telephone_number": "702-649-5995",
            "fax_number": "702-399-9801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 W OAKEY BLVD STE A3-4",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891460391",
            "telephone_number": "702-377-1198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3840 N Commerce St",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "North Las Vegas",
            "state": "NV",
            "postal_code": "890328104",
            "country_code": "US",
            "telephone_number": "702-649-5995",
            "fax_number": "702-399-9801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANTOINETTE",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-19",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": "NV",
            "license": "1404123254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel A Jackson
• Anitra Jackson
• Anthony Jackson
• Anthony D Jackson
• Antoinette Jackson
• Antonia Jackson
• Antuan Jackson
• Ashley Jackson
• Author Jackson
• Betty Jackson

• Personal Care Attendant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Personal Care Attendant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.

Verify at the official NPI Registry.