Jacksons Health Family Health NP

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

JACKSONS HEALTH FAMILY HEALTH NP

Practice address

1655 Elmwood Ave Ste 125
Rochester, NY 14620-3428

Phone

(585) 340-6940

NPI assigned

Sep 7, 2021

Organization subpart

No

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

Authorized official

Name

Carnel Jackson, FNPNPI 1336523257

Title

Owner

Phone

(585) 340-6940

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carnel Jackson, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Rochester, NY
  • NPI 1336523257
  Medicare reassignment Care Compare group NPD Authorized official
• Corey Jerrod Jackson, NP

  • Family Nurse Practitioner
  • Rochester, NY
  • NPI 1427432343
  Medicare reassignment Care Compare group NPD
• John O'Ryan, LMHC

  • Professional Counselor
  • Kirkwood, NY
  • NPI 1770049579
  Medicare reassignment Care Compare group NPD
• Mariana Menting de Alba, FNP-C

  • Family Nurse Practitioner
  • Rochester, NY
  • NPI 1740165299
  Medicare reassignment NPD
• Bryanna Unique Patterson, MS, FNP-BC

  • Family Nurse Practitioner
  • Rochester, NY
  • NPI 1386324549
  Medicare reassignment NPD
• Eric Alan Kerr, P.A.

  • Physician Assistant
  • Rochester, NY
  • NPI 1760421341
  Medicare reassignment
• Katherine W Rowles, RN, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Pittsford, NY
  • NPI 1649559329
  Medicare reassignment
• Michelle Janine Squicciarini-Beterbiyev, LMHC

  • Mental Health Counselor
  • Rochester, NY
  • NPI 1306471784
  Medicare reassignment

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725753600000",
    "number": "1194494880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "978 CLINTON AVE S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202040",
            "telephone_number": "585-576-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 ELMWOOD AVE STE 125",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146203428",
            "telephone_number": "585-340-6940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1815 S Clinton Ave Ste 610",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146185723",
            "country_code": "US",
            "telephone_number": "585-340-6940",
            "fax_number": "585-348-2045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JACKSONS HEALTH FAMILY HEALTH NP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-07",
        "last_updated": "2024-09-08",
        "certification_date": "2024-09-08",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "CARNEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-340-6940",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tony Jackson
• Tori Jackson
• Tracey Monique Jackson, RN
• Vanessa Jackson, LPN
• William L Jackson, P.T.
• Jacksons Transportaion Service
• Seth Christopher Jacob-Wagner, NP
• Tom Jacob, DO
• Andree Jacobs-Perkins, M.D.
• Carolyn Yvette Jacobs, MD

• Primary Care Clinic/Center in Rochester, NY
• Providers in Rochester, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.