Active NPI
Lashanda Janice Jackson
- Licensed Practical Nurse
- Center Line, MI
National Provider Identifier
1225525603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 4703101476
- Practice address
- 8033 E 10 Mile Rd Ste 114
Center Line, MI 48015-1454 - Phone
- (586) 756-6661
- Fax
- (586) 756-6933
- NPI assigned
- Apr 20, 2018
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 4703101476 | MI | Primary |
Addresses
Primary practice location
8033 E 10 Mile Rd Ste 114
Center Line, MI 48015-1454
Mailing address
8033 E 10 Mile Rd Ste 114
Center Line, MI 48015-1454
Phone (586) 756-6661
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4703101476 | MI | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand Home Care, LLC | Past | Accepting new patients | |
| Atrium Home & Healthcare Services Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Home Health Agency
- Center Line, MI
- NPI 1043436470
-
- Home Health Agency
- Center Line, MI
- NPI 1528223666
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524182400000",
"number": "1225525603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8033 E 10 MILE RD STE 114",
"city": "CENTER LINE",
"state": "MI",
"postal_code": "480151454",
"telephone_number": "586-756-6661",
"fax_number": "586-756-6933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8033 E 10 MILE RD STE 114",
"city": "CENTER LINE",
"state": "MI",
"postal_code": "480151454",
"telephone_number": "586-756-6661",
"fax_number": "586-756-6933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "LASHANDA",
"middle_name": "JANICE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-20",
"last_updated": "2018-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "MI",
"license": "4703101476",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Center Line, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.