Ann Patricia Jackson, LPC, NCC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

4131 Issued in NC

Practice address

200 Elkin Business Park Dr
Elkin, NC 28621-3159

Phone

(336) 835-1000

Fax

(336) 835-1075

NPI assigned

Dec 18, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Crossroads Behavioral Healthcare

  • Community/Behavioral Health Agency
  • Elkin, NC
  • NPI 1124260120
  NPD (past)
• Crossroads Behavioral Healthcare

  • Community/Behavioral Health Agency
  • Elkin, NC
  • NPI 1649333113
  NPD (past)

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1114101896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ELKIN BUSINESS PARK DR",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286213159",
            "telephone_number": "336-835-1000",
            "fax_number": "336-835-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ELKIN BUSINESS PARK DR",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286213159",
            "telephone_number": "336-835-1000",
            "fax_number": "336-835-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANN",
        "middle_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-18",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NC",
            "license": "4131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hugh Chatham Memorial Hospital, Inc.
• Bobbi Hurst
• Steven Isaacs, MD
• Ginger Isenhoward, LCMHC, NCC
• Philip James Iuliano, M.D.
• William Prescott Jarrett, PA-C
• Megan Jaynes, CNM
• George Perry Jernigan II, DDS
• Jim a. Harrell, Jr., D.D.S., PA
• Brooke Patterson Johnson, CCC-SLP

• Health Maintenance Organization in Elkin, NC
• Providers in Elkin, NC by specialty
• Health Maintenance Organization in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; 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.