Individual provider Active NPI

Kayla Carol Jackson

  • Adult Companion
  • Trenton, NJ
National Provider Identifier
1174403646
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult CompanionTaxonomy code 372600000X
Practice address
1112 Riverside Ave Apt 3G
Trenton, NJ 08618-5243
Phone
(609) 815-5442
NPI assigned
Sep 5, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult CompanionGroup: 193400000X SINGLE SPECIALTY GROUP 372600000X AZ Primary

Addresses

Primary practice location

1112 Riverside Ave Apt 3G
Trenton, NJ 08618-5243

Mailing address

1112 Riverside Ave Apt 3G
Trenton, NJ 08618-5243
Phone (609) 815-5442

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

NPI Registry JSON

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

{
    "created_epoch": "1757030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1174403646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 RIVERSIDE AVE APT 3G",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086185243",
            "telephone_number": "609-815-5442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 RIVERSIDE AVE APT 3G",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086185243",
            "telephone_number": "609-815-5442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KAYLA",
        "middle_name": "CAROL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-05",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Adult Companion",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; 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.