Individual provider Active NPI

Shawna Jackson

  • Case Manager/Care Coordinator
  • Soldotna, AK
National Provider Identifier
1194158436
Registry record updated Aug 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
47202 Princeton Ave
Soldotna, AK 99669-8242
Phone
(907) 420-3600
NPI assigned
Aug 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

47202 Princeton Ave
Soldotna, AK 99669-8242

Mailing address

47202 Princeton Ave
Soldotna, AK 99669-8242
Phone (907) 420-3600

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": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1194158436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47202 PRINCETON AVE",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996698242",
            "telephone_number": "907-420-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47202 PRINCETON AVE",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996698242",
            "telephone_number": "907-420-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHAWNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-09",
        "last_updated": "2013-08-09",
        "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 Soldotna, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.