Active NPI
Joshua Rashad Jackson Sr.
- In Home Supportive Care Agency
- Milwaukee, WI
National Provider Identifier
1194372243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Practice address
- 6340 N 84TH St Apt 5
Milwaukee, WI 53225-1972 - Phone
- (414) 233-5907
- NPI assigned
- Aug 22, 2019
- Last updated
- Nov 27, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | Primary |
Addresses
Primary practice location
6340 N 84TH St Apt 5
Milwaukee, WI 53225-1972
Mailing address
N67W13215 Daylily Dr
Menomonee Falls, WI 53051-0504
Phone (414) 233-5907
Other practice location 1
6340 N 84th St Apt 5
Milwaukee, WI 53225-1972
Phone (414) 233-5907
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 832046773 | Medicaid | WI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Golden.Comfort@yahoo.com | Direct |
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": "1566432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1194372243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N67W13215 DAYLILY DR",
"city": "MENOMONEE FALLS",
"state": "WI",
"postal_code": "530510504",
"telephone_number": "414-233-5907",
"fax_number": "262-345-5550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6340 N 84TH ST APT 5",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532251972",
"telephone_number": "414-233-5907"
}
],
"practiceLocations": [
{
"address_1": "6340 N 84th St Apt 5",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532251972",
"country_code": "US",
"telephone_number": "414-233-5907",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "JOSHUA",
"middle_name": "RASHAD",
"name_suffix": "Sr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-08-22",
"last_updated": "2023-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "832046773",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Golden.Comfort@yahoo.com",
"affiliation": "Y",
"endpointDescription": "Business Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Supportive Living",
"address_1": "6340 N 84th St Apt 5",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532251972",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.