Active NPI
Ostassia Jackson
- Home Health Agency
- Mequon, WI
National Provider Identifier
1083342315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Practice address
- 11431 N Port Washington Rd Ste 206
Mequon, WI 53092-3462 - Phone
- (414) 319-9195
- NPI assigned
- Aug 14, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | |||
| Lodging Provider | 177F00000X | |||
| Homemaker | 376J00000X | |||
| Nurse's Aide | 376K00000X | |||
| Respite Care | 385H00000X | |||
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
11431 N Port Washington Rd Ste 206
Mequon, WI 53092-3462
Mailing address
11431 N Port Washington Rd Ste 206
Mequon, WI 53092-3462
Phone (414) 319-9195
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jacksono@urbanlyculturedmke.com |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660435200000",
"number": "1083342315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11431 N PORT WASHINGTON RD STE 206",
"city": "MEQUON",
"state": "WI",
"postal_code": "530923462",
"telephone_number": "414-319-9195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11431 N PORT WASHINGTON RD STE 206",
"city": "MEQUON",
"state": "WI",
"postal_code": "530923462",
"telephone_number": "414-319-9195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "OSTASSIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-14",
"last_updated": "2022-08-14",
"certification_date": "2022-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": null,
"license": null,
"primary": false
},
{
"code": "177F00000X",
"taxonomy_group": "",
"desc": "Lodging",
"state": null,
"license": null,
"primary": false
},
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": null,
"license": null,
"primary": false
},
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jacksono@urbanlyculturedmke.com",
"affiliation": "N",
"endpointDescription": "Ostassia's UC Work email",
"address_1": "11431 N Port Washington Rd Ste 206",
"city": "Mequon",
"state": "WI",
"country_code": "US",
"postal_code": "530923462",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Mequon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.