Ebony Jamice Jackson, RN

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

RN.346657 Issued in OH

Practice address

3601 Shady Timber Dr
Twinsburg, OH 44087-4945

Phone

(216) 296-4817

NPI assigned

Oct 9, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Ebony Jamice Hall Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Covenant Home Care, LLC

  • In Home Supportive Care Agency
  • Twinsburg, OH
  • NPI 1124683503
  NPD Authorized official

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1225636582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 SHADY TIMBER DR",
            "city": "TWINSBURG",
            "state": "OH",
            "postal_code": "440874945",
            "telephone_number": "216-296-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 SHADY TIMBER DR",
            "city": "TWINSBURG",
            "state": "OH",
            "postal_code": "440874945",
            "telephone_number": "216-296-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "EBONY",
        "middle_name": "JAMICE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "OH",
            "license": "RN.346657",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "OH",
            "license": "RN.346657",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "OH",
            "license": "RN.346657",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": "OH",
            "license": "RN.346657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EBONY",
            "last_name": "HALL",
            "middle_name": "JAMICE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Innovative Health Services
• Inspire Connections Therapy
• Integrated Healthcare Service LLC
• Integrative Chiropractic Clinic LLC
• Integrity Home Healthcare of Hudson, LLC
• Lesley Marie Jacobs, R.N.
• Michael S Janesch, PT
• Jessica M Jenkins, CNP, MSN
• Jeffrey Harvey Jinks, M.D.
• Johnson Taylor DDS Inc

• Home Health Registered Nurse in Twinsburg, OH
• Providers in Twinsburg, OH by specialty
• Home Health Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.