Active NPI
Donna R. Jackson, DONNA JACKSON, PH.D.
- Clinical Psychologist
- Cincinnati, OH
National Provider Identifier
1235280645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2146
- Practice address
- 2724 Madison Rd
Cincinnati, OH 45209-2209 - Phone
- (513) 631-9922
- NPI assigned
- Jan 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2146 | OH | Primary |
Addresses
Primary practice location
2724 Madison Rd
Cincinnati, OH 45209-2209
Mailing address
2724 Madison Rd
Cincinnati, OH 45209-2209
Phone (513) 631-9922
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 1, 2019 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2146 | OH | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458518400000",
"number": "1235280645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2724 MADISON RD",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452092209",
"telephone_number": "513-631-9922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2724 MADISON RD",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452092209",
"telephone_number": "513-631-9922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "DONNA",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "DONNA JACKSON, PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-13",
"last_updated": "2016-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "2146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.