Individual provider Active NPI

Tiffany Monique Jackson

  • Personal Care Attendant
  • Washington, DC
National Provider Identifier
1225793144
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Practice address
120 45TH St NE Apt 604
Washington, DC 20019-4790
Phone
(301) 237-1512
NPI assigned
Nov 4, 2021
Last updated
Nov 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X DC Primary

Addresses

Primary practice location

120 45TH St NE Apt 604
Washington, DC 20019-4790

Mailing address

3509 Hayes St NE Unit B
Washington, DC 20019-7502
Phone (202) 766-4858

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": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1225793144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 HAYES ST NE UNIT B",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200197502",
            "telephone_number": "202-766-4858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 45TH ST NE APT 604",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200194790",
            "telephone_number": "301-237-1512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TIFFANY",
        "middle_name": "MONIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-04",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "DC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.

Verify at the official NPI Registry.