Active NPI
Jason Jackson, BS
- Case Manager/Care Coordinator
- Albuquerque, NM
National Provider Identifier
1174348155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 10052 Coors Blvd NW
Albuquerque, NM 87114-4020 - Phone
- (505) 459-0025
- Fax
- (505) 899-8372
- NPI assigned
- Nov 15, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
10052 Coors Blvd NW
Albuquerque, NM 87114-4020
Mailing address
PO Box 66255
Albuquerque, NM 87193-6255
Phone (505) 459-0025
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
- Credentials
- Bachelor of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellness From Within PC | 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.
-
- Community/Behavioral Health Agency
- Albuquerque, NM
- NPI 1346586989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731628800000",
"number": "1174348155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 66255",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871936255",
"telephone_number": "505-459-0025",
"fax_number": "505-899-8372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10052 COORS BLVD NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871144020",
"telephone_number": "505-459-0025",
"fax_number": "505-899-8372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JASON",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-11-15",
"last_updated": "2024-11-15",
"certification_date": "2024-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.