Erica B. Jackson, M.D., LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD 200224 Issued in LA

Legal business name

ERICA B. JACKSON, M.D., LLC

Practice address

2002 20TH St
Suite A101
Kenner, LA 70062-6289

Phone

(504) 305-4232

NPI assigned

Apr 8, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Erica Brown Jackson, M.D.

Title

Owner

Phone

(504) 305-4232

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1365379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365379200000",
    "number": "1205279478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 LAUREL OAK DR",
            "city": "SAINT ROSE",
            "state": "LA",
            "postal_code": "700873241",
            "telephone_number": "504-717-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 20TH ST",
            "address_2": "SUITE A101",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700626289",
            "telephone_number": "504-305-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICA B. JACKSON, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-08",
        "last_updated": "2013-04-08",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "BROWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-305-4232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD 200224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Kenner, LA
• Providers in Kenner, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.