Active NPI
Deborah Jackson
- Registered Nurse
- Chester, PA
National Provider Identifier
1174051114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN559912
- Practice address
- 405 Avenue of the States
Chester, PA 19013-4403 - Phone
- (484) 483-9413
- Fax
- (484) 766-3192
- NPI assigned
- Jun 2, 2017
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN559912 | PA | Primary |
Addresses
Primary practice location
405 Avenue of the States
Chester, PA 19013-4403
Mailing address
405 Avenue of the States
Chester, PA 19013-4403
Phone (484) 483-9413
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN559912 | PA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Penn Home Health Care LLC | Registered Nurse | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1174051114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 AVENUE OF THE STATES",
"city": "CHESTER",
"state": "PA",
"postal_code": "190134403",
"telephone_number": "484-483-9413",
"fax_number": "484-766-3192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 AVENUE OF THE STATES",
"city": "CHESTER",
"state": "PA",
"postal_code": "190134403",
"telephone_number": "484-483-9413",
"fax_number": "484-766-3192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "DEBORAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-02",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "PA",
"license": "RN559912",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chester, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.