Active NPI
Courtney N Jackson
- Technician/Technologist
- Bingham Farms, MI
National Provider Identifier
1124582267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Technician/Technologist
- Practice address
- 31200 Telegraph Rd Ste 205
Bingham Farms, MI 48025 - Phone
- (248) 712-4266
- NPI assigned
- Jan 23, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Technician/Technologist | 156F00000X | Primary |
Addresses
Primary practice location
31200 Telegraph Rd Ste 205
Bingham Farms, MI 48025
Mailing address
31200 Telegraph Rd Ste 205
Bingham Farms, MI 48025
Phone (248) 712-4266
Other practice location 1
27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5326
Phone (248) 436-4476
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": "1548201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555459200000",
"number": "1124582267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31200 TELEGRAPH RD STE 205",
"city": "BINGHAM FARMS",
"state": "MI",
"postal_code": "48025",
"telephone_number": "248-712-4266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31200 TELEGRAPH RD STE 205",
"city": "BINGHAM FARMS",
"state": "MI",
"postal_code": "48025",
"telephone_number": "248-712-4266"
}
],
"practiceLocations": [
{
"address_1": "27777 Inkster Rd Ste 100",
"address_purpose": "LOCATION",
"city": "Farmington Hills",
"state": "MI",
"postal_code": "483345326",
"country_code": "US",
"telephone_number": "248-436-4476",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "COURTNEY",
"middle_name": "N",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-23",
"last_updated": "2019-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "156F00000X",
"taxonomy_group": "",
"desc": "Technician/Technologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bingham Farms, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.