Laura Jackson, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

30381 Chieftain Dr
Logan, OH 43138-9092

Phone

(740) 385-2555

Fax

(740) 773-4032

NPI assigned

Jan 21, 2021

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 OH

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Hopewell Health Centers Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Athens, OH
  • NPI 1699010348
  Medicare reassignment NPD
• Hopewell Health Centers Inc

  • Respite Care
  • Athens, OH
  • NPI 1750893871
  NPD
• Hopewell Health Centers, Inc.

  • Community/Retail Pharmacy
  • The Plains, OH
  • NPI 1215777230
  NPD

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1073103321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456010188",
            "telephone_number": "740-773-4366",
            "fax_number": "740-773-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30381 CHIEFTAIN DR",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431389092",
            "telephone_number": "740-385-2555",
            "fax_number": "740-773-4032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LAURA",
        "credential": "LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lexie Hyme, RPH TECH
• Sheila A Ingraham, LCDCIII
• Nida Iqbal
• John A Ireton, D.O.
• Autumn Marie Jackson
• Bethany Ann Jagers, CNP
• Sierra L John, LSW
• April Lynn Johnson, RPH TECH
• Christopher Johnson
• Kaitlyn Melissa Johnson, SWT

• Registered Dietitian in Logan, OH
• Providers in Logan, OH by specialty
• Registered Dietitian in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.