Active NPI
Darneshia Jackson
- Case Manager/Care Coordinator
- Milwaukee, WI
National Provider Identifier
1073100962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 5220 N 67TH St
Milwaukee, WI 53218-3017 - Phone
- (414) 323-3792
- NPI assigned
- Dec 25, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
5220 N 67TH St
Milwaukee, WI 53218-3017
Mailing address
5220 N 67TH St
Milwaukee, WI 53218-3017
Phone (414) 323-3792
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 854230292 | Medicaid | WI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Darneshia | Direct |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Support Services | Current | Accepting new patients | |
| My Bundles of Joy LLC | Case Manager/Care Coordinator | Current | Accepting new patients |
Organizations & group practices 2
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.
-
- Case Manager/Care Coordinator
- Milwaukee, WI
- NPI 1265024491
-
- Case Management Agency
- Mansfield, TX
- NPI 1588317606
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629417600000",
"number": "1073100962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5220 N 67TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532183017",
"telephone_number": "414-323-3792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5220 N 67TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532183017",
"telephone_number": "414-323-3792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "DARNESHIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-25",
"last_updated": "2021-08-20",
"certification_date": "2021-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "854230292",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Darneshia",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "5220 N 67th St",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532183017",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.