Active NPI
Chanel D Jackson
- Case Manager/Care Coordinator
- Los Angeles, CA
National Provider Identifier
1205492279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 1355 S Hill St
Los Angeles, CA 90015-3012 - Phone
- (213) 389-5820
- NPI assigned
- May 15, 2019
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
1355 S Hill St
Los Angeles, CA 90015-3012
Mailing address
550 S Vermont Ave RM 904
Los Angeles, CA 90020-1912
Phone (213) 738-4775
Other practice location 1
437 N Hoover St
Los Angeles, CA 90004-2306
Phone (323) 666-0705
Other practice location 2
3455 Percy St
Los Angeles, CA 90023-1716
Phone (323) 268-2100
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": "1557878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557878400000",
"number": "1205492279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 S VERMONT AVE RM 904",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900201912",
"telephone_number": "213-738-4775",
"fax_number": "213-632-5892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1355 S HILL ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900153012",
"telephone_number": "213-389-5820"
}
],
"practiceLocations": [
{
"address_1": "437 N Hoover St",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900042306",
"country_code": "US",
"telephone_number": "323-666-0705",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3455 Percy St",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900231716",
"country_code": "US",
"telephone_number": "323-268-2100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "CHANEL",
"middle_name": "D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-15",
"last_updated": "2019-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.