Melinda Louise Jackson, CRNP

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

1-117801 Issued in AL

Practice address

400 Taylor Rd
Montgomery, AL 36117-3511

Phone

(205) 335-7683

NPI assigned

Nov 12, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Melinda Louise Zuk Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1225673445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 TAYLOR RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173511",
            "telephone_number": "205-335-7683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 TAYLOR RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173511",
            "telephone_number": "205-335-7683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2010 Brookwood Medical Ctr Dr",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352096804",
            "country_code": "US",
            "telephone_number": "205-335-7683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MELINDA",
        "middle_name": "LOUISE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-12",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-117801",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "AL",
            "license": "1-117801",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "AL",
            "license": "1-117801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Birmingham",
            "affiliation": "N",
            "address_1": "2010 Brookwood Medical Ctr Dr",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352096804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MELINDA",
            "last_name": "ZUK",
            "middle_name": "LOUISE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Latoya Jackson
• Laura Gail Jackson, ALC
• Lydia Lane Jackson, PA C
• Marilyn Sledge Jackson, LCSW
• Megan Jackson
• Nakisa J Jackson
• Renita L Jackson
• Sheila Jackson
• Taylor Nichole Jackson
• William R Jackson Jr., PT

• Neonatal Nurse Practitioner in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Neonatal Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.