NPIMap

Individual provider Active NPI

Kristina Yvette Jackson

  • Hearing Instrument Specialist
  • North Royalton, OH
National Provider Identifier
1083042345
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
03151 Issued in OH
Practice address
6548 Royalton Rd Ste 101
North Royalton, OH 44133-4976
Phone
(440) 305-2822
NPI assigned
Oct 24, 2013
Last updated
Feb 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 691-S OH
Hearing Instrument Specialist 237700000X 03151 OH Primary

Addresses

Primary practice location

6548 Royalton Rd Ste 101
North Royalton, OH 44133-4976

Mailing address

11285 Drake Rd
North Royalton, OH 44133-5405
Phone (440) 305-2822

Other practice location 1

7425 Royalton Rd
North Royalton, OH 44133-4743
Phone (440) 305-2822

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

State licenses

LicenseStateTypeSpecialty
691-SOHMDOptician
03151OHMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Hear Now Network Hearing Instrument Specialist CurrentSince Feb 12, 2023 Accepting new patients
Sounds Like a Plan Hearing Instrument Specialist CurrentSince Feb 12, 2023 Accepting new patients
Sounds Like a Plan Hearing Instrument Specialist PastSince Feb 12, 2023 Accepting new patients

Locations

6548 Royalton Rd
Ste 101
North Royalton, OH 44133
Phone (440) 305-2822

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1083042345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11285 DRAKE RD",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441335405",
            "telephone_number": "440-305-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6548 ROYALTON RD STE 101",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441334976",
            "telephone_number": "440-305-2822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7425 Royalton Rd",
            "address_purpose": "LOCATION",
            "city": "North Royalton",
            "state": "OH",
            "postal_code": "441334743",
            "country_code": "US",
            "telephone_number": "440-305-2822",
            "fax_number": "440-457-7712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KRISTINA",
        "middle_name": "YVETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-24",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "OH",
            "license": "691-S",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "OH",
            "license": "03151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Royalton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.