Cenethia Lasha Jackson

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN5176478 Issued in FL

Practice address

439 SW Michigan St
Lake City, FL 32025-0440

Phone

(386) 487-0800

NPI assigned

Apr 9, 2009

Sex

Female

Sole proprietor

No

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

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.

• C and J Transport Legacy LLC

  • Non-emergency Medical Transport (VAN)
  • Lulu, FL
  • NPI 1336868207
  NPD Authorized official

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239235200000",
    "number": "1053554873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 SW MICHIGAN ST",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320250440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 SW MICHIGAN ST",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320250440",
            "telephone_number": "386-487-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CENETHIA",
        "middle_name": "LASHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-09",
        "last_updated": "2009-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5176478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luisa M. Irizarry
• John V Irwin, RRT
• Allison Ivey
• Treless Ivey
• Osayande Stephen Izeiyamu, MD
• Dorothy Jackson
• Johnna L Jackson, ARNP
• Lareesa Jackson
• Mardell Jackson
• Raven Jackson

• Licensed Practical Nurse in Lake City, FL
• Providers in Lake City, FL by specialty
• Licensed Practical Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; 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.