Nicole Navika Jackson, CPT

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

Practice address

1035 Scales Rd Apt 4311
Suwanee, GA 30024-2530

Phone

(678) 717-9342

NPI assigned

Apr 5, 2021

Last updated

Jun 30, 2024By the provider in NPPES

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

Practice roles

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.

• Beating Heart Services

  • Point of Service
  • Lawrenceville, GA
  • NPI 1043961550
  NPD (past) Authorized official

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719705600000",
    "number": "1144809427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 SCALES RD APT 4311",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242530",
            "telephone_number": "678-717-9342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 SCALES RD APT 4311",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242530",
            "telephone_number": "678-717-9342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "NICOLE",
        "middle_name": "NAVIKA",
        "credential": "CPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2024-06-30",
        "certification_date": "2024-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J & J Physical Therapy LLC
• J. S. Maddox Consulting, LLC
• Craig Lebern Jackson, RN
• Delaney Madisen Jackson, CNM
• Markaya Jackson, RBT
• Simone Jackson
• Tobin Pottas Jacob, PHARMD
• Jae Lee DDS LLC
• Byung Jae
• Jyoti Jain

• Phlebotomy Technician in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Phlebotomy Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.