Individual provider Active NPI

Sarah Lynn Jackson, RN

  • Registered Nurse
  • Waukon, IA
National Provider Identifier
1043776404
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
128088 Issued in IA
Practice address
985 Forest Mills Rd
Waukon, IA 52172-7574
Phone
(563) 794-0662
NPI assigned
Feb 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 128088 IA Primary

Addresses

Primary practice location

985 Forest Mills Rd
Waukon, IA 52172-7574

Mailing address

985 Forest Mills Rd
Waukon, IA 52172-7574
Phone (563) 794-0662

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
128088IAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1043776404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985 FOREST MILLS RD",
            "city": "WAUKON",
            "state": "IA",
            "postal_code": "521727574",
            "telephone_number": "563-794-0662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985 FOREST MILLS RD",
            "city": "WAUKON",
            "state": "IA",
            "postal_code": "521727574",
            "telephone_number": "563-794-0662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SARAH",
        "middle_name": "LYNN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-11",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IA",
            "license": "128088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukon, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; 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.