Kenneth Lee Jackson
Individual provider Active NPI Non-emergency Medical Transport (VAN) · Lake Charles, LA
NPI 1154058162 · NPPES record last updated Aug 1, 2022
Key facts
- NPI
- 1154058162
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Non-emergency Medical Transport (VAN) 343900000X
- Practice address
- 1216 Oklahoma St
Lake Charles, LA 70607-3624 - Phone
- (337) 414-0914
- NPI assigned
- Aug 1, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pic Me Up Medical Transportation Services LLC | Non-Emergency Medical Transport (Van) | Current |
Accepting new patients |
| Kenneth Jackson | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Non-emergency Medical Transport (VAN) | 343900000X | Yes |
Addresses
Primary practice location
1216 Oklahoma St
Lake Charles, LA 70607-3624
Mailing address
1216 Oklahoma St
Lake Charles, LA 70607-3624
Phone (337) 414-0914
Other providers in Lake Charles, LA
- Helene M Jackson
- J Lene Jackson
- Jada Jackson
- James Jackson
- Kelechi Ihuoma Jackson
- Louella M Jackson
- Naomi Jefferson Jackson
- Shameka Jackson
- Jacob Dent DDS Dentists of Lake Charles a Proffessional Corporation
- Brenna Thomas Jacob
All providers in Lake Charles, LA · Non-emergency Medical Transport (VAN) in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.