Callie Rae Jackson

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

10520 S 123Rd Ave
Papillion, NE 68046-4393

Phone

(402) 514-3650

NPI assigned

Sep 7, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1184345241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10520 S 123RD AVE",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680464393",
            "telephone_number": "402-514-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10520 S 123RD AVE",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680464393",
            "telephone_number": "402-514-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CALLIE",
        "middle_name": "RAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3747P1801X",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "callie.jackson@plcschools.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Prairie Queen Elementary",
            "address_1": "10520 S 123rd Ave",
            "city": "Papillion",
            "state": "NE",
            "country_code": "US",
            "postal_code": "680464393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Makayla Ingram
• Dan Innes
• Inspire Your Why Company
• Darrell Dean Irvine, PMHP
• Scott Douglas Irvine, M.D.
• Deborah Jackson
• Janice C Jackson
• Lacey Michelle Jackson, D.C.
• Taffy Linnea Jacob, PHARM D
• Jocelyne Jacobi

• Personal Care Attendant in Papillion, NE
• Providers in Papillion, NE by specialty
• Personal Care Attendant in Nebraska

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

Verify at the official NPI Registry.