Active NPI
Sharley Rene Jackman, RD
- Registered Dietitian
- Colorado Springs, CO
National Provider Identifier
1205420452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 1254 Lady Campbell Dr
Colorado Springs, CO 80905-4440 - Phone
- (785) 650-1878
- NPI assigned
- Feb 26, 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
1254 Lady Campbell Dr
Colorado Springs, CO 80905-4440
Mailing address
1254 Lady Campbell Dr
Colorado Springs, CO 80905-4440
Phone (785) 650-1878
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": "1614297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614297600000",
"number": "1205420452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1254 LADY CAMPBELL DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809054440",
"telephone_number": "785-650-1878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1254 LADY CAMPBELL DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809054440",
"telephone_number": "785-650-1878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKMAN",
"first_name": "SHARLEY",
"middle_name": "RENE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-26",
"last_updated": "2021-02-26",
"certification_date": "2021-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.