Andria Jackson

Primary specialty

Prosthetics Case ManagementTaxonomy code 1744P3200X

License

407120 Issued in MD

Practice address

9560 Marlboro Pike Ste 105
Upper Marlboro, MD 20772-3770

Phone

(301) 535-7542

NPI assigned

Jun 12, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Natural Touch Hair Studio Inc

  • Case Management Agency
  • Upper Marlboro, MD
  • NPI 1255956181
  NPD Authorized official

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

{
    "created_epoch": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1073138285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9560 MARLBORO PIKE STE 105",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723770",
            "telephone_number": "301-535-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9560 MARLBORO PIKE STE 105",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723770",
            "telephone_number": "301-535-7542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANDRIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-12",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "MD",
            "license": "407120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COSMETOLOGY LICENCE",
            "identifier": "407120",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "nthairlosshairextensionstudio.com",
            "affiliation": "N",
            "endpointDescription": "business website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9560 Marlboro Pike Ste 105",
            "city": "Upper Marlboro",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207723770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eunice Iwuchukwu
• Izzy Transport LLC
• Musa Jabbie
• Maranda C Jackson-Parkin, CRNP-BC
• Leslie Jackson-Vallade, LDN
• Arielle M Jackson, RMP
• Ayana Beatrice Jackson
• Bettina Monet Jackson, MS CCC-SLP
• Candace Jackson
• Crystal Jackson, BIRTH DOULA

• Prosthetics Case Management in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Prosthetics Case Management in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.