Carol Bowser Jackson, RN

Primary specialty

Occupational Health Registered NurseTaxonomy code 163WX0106X

License

R103314 Issued in MD

Practice address

9501 Farrell Rd
BLDG 815,RM 139
Fort Belvoir, VA 22060-5901

Phone

(703) 805-0498

NPI assigned

Nov 9, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063582864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5805 TERENCE DR",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353742",
            "telephone_number": "301-856-5259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 FARRELL RD",
            "address_2": "BLDG 815,RM 139",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605901",
            "telephone_number": "703-805-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CAROL",
        "middle_name": "BOWSER",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0106X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Occupational Health",
            "state": "MD",
            "license": "R103314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING",
            "identifier": "R103314",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Christopher Inocencio, M.D.
• Stefan Inouye
• Macon Loshawn Irick, LCSW
• Georgina Irondi, LCSW-C
• Leticia Salo Isidro-Clancy, MA, LPC-MFT, LADC
• Regina Lynne Jacobs, RDH
• John M Jacocks, M.D.
• Ashley Alexandra Jaeger, M.D.
• Bonnie Freid James, PA-C
• Tamara J James, LCSW

• Occupational Health Registered Nurse in Fort Belvoir, VA
• Providers in Fort Belvoir, VA by specialty
• Occupational Health Registered Nurse in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.