Jacksonscott2

Primary specialty

Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X

License

317445-31 Issued in WI

Legal business name

JACKSONSCOTT2

Practice address

4573 N. 22ND Street
Milwaukee, WI 53209

Phone

(414) 517-2825

NPI assigned

Feb 7, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Latasha Jackson, LPNNPI 1801369111

Title

LPN

Phone

(414) 517-2825

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Latasha Jackson, LPN

  • Licensed Practical Nurse
  • Milwaukee, WI
  • NPI 1801369111
  NPD (past) Authorized official

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486425600000",
    "number": "1154869410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4573 N 22ND ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532096309",
            "telephone_number": "414-517-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4573 N. 22ND STREET",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53209",
            "telephone_number": "414-517-2825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONSCOTT2",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-07",
        "last_updated": "2017-02-07",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "LATASHA",
        "authorized_official_title_or_position": "LPN",
        "authorized_official_telephone_number": "414-517-2825",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "WI",
            "license": "317445-31",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronda Jackson
• Vickie Lee Jackson
• Victoria Cassandra Jackson, LCSW
• Vinice Jackson
• Vonte Jackson, DDS
• Necha Devorah Jacob, LPC
• Arica Lynn Jacobs, DPT
• Camille Olivia Jacobs
• Dora A. Jacobs, NP
• Elizabeth Jacobs, MD

• Pediatric Skilled Nursing Facility in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Pediatric Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; 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.