Jennifer Ann Jackson, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

912823 Issued in CA

Practice address

1600 Weeot Way
Arcata, CA 95521-4734

Phone

(707) 825-5000

Fax

(707) 825-5030

NPI assigned

May 23, 2008

Last updated

May 23, 2008By the provider in NPPES

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

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15156/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Consolidated Tribal Health Project, Inc.

  • Health Service Clinic/Center
  • Redwood Valley, CA
  • NPI 1003826009
  Medicare reassignment NPD
• K'Ima:W Medical Center

  • Clinic/Center
  • Hoopa, CA
  • NPI 1306904222
  Medicare reassignment NPD
• K'Ima:W Medical Center

  • Clinic/Center
  • Hoopa, CA
  • NPI 1861661365
  NPD
• Tele-Medicine Services Ny, PLLC

  • Internal Medicine Physician
  • Roseville, CA
  • NPI 1609663780
  NPD (past)

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211500800000",
    "number": "1053579284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 WEEOT WAY",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955214734",
            "telephone_number": "707-825-5000",
            "fax_number": "707-825-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 WEEOT WAY",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955214734",
            "telephone_number": "707-825-5000",
            "fax_number": "707-825-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2008-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "912823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyli Huynh
• Ibs Food Allergy Centers
• Sara Ikenberry
• Lianna Elizabeth Iniguez
• Evan Jackson
• Krystal Jacob, PSYD
• Joseph Simpson Jacobs
• Molly Jacobs, FNP
• Jade Dragon Medical Spa
• Erik J Jansson, MD

• Registered Dietitian in Arcata, CA
• Providers in Arcata, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.