Active NPI
Tracey Francine Jackson
- Other Technician
- Eastpointe, MI
National Provider Identifier
1134571730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- Practice address
- 22764 Normandy Ave
Eastpointe, MI 48021-1854 - Phone
- (313) 782-6777
- NPI assigned
- Jul 7, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | Primary |
Addresses
Primary practice location
22764 Normandy Ave
Eastpointe, MI 48021-1854
Mailing address
22764 Normandy Ave
Eastpointe, MI 48021-1854
Phone (313) 782-6777
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": "1467849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467849600000",
"number": "1134571730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22764 NORMANDY AVE",
"city": "EASTPOINTE",
"state": "MI",
"postal_code": "480211854",
"telephone_number": "313-782-6777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22764 NORMANDY AVE",
"city": "EASTPOINTE",
"state": "MI",
"postal_code": "480211854",
"telephone_number": "313-782-6777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "TRACEY",
"middle_name": "FRANCINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-07",
"last_updated": "2016-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eastpointe, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.