Active NPI
Davin Jackson
- Social Worker
- Independence, MO
National Provider Identifier
1194315945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 3737 S Elizabeth St
Independence, MO 64057-1759 - Phone
- (816) 795-1484
- NPI assigned
- Jan 25, 2021
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
3737 S Elizabeth St
Independence, MO 64057-1759
Mailing address
3317 Askew Ave
Kansas City, MO 64128-2043
Phone (813) 813-1904
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": "1611532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611532800000",
"number": "1194315945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3317 ASKEW AVE",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641282043",
"telephone_number": "813-813-1904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3737 S ELIZABETH ST",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640571759",
"telephone_number": "816-795-1484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "DAVIN",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-25",
"last_updated": "2021-01-25",
"certification_date": "2021-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Independence, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.