Tammy J Jackson, LICENSED PSYCHOLOGIS

Primary specialty

PsychologistTaxonomy code 103T00000X

License

01757 Issued in MO

Practice address

1272 NE Windsor Dr
Lees Summit, MO 64086-5594

Phone

(816) 246-4465

NPI assigned

Dec 22, 2006

Last updated

Oct 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healing Grace Ministries, Inc

  dba Healing Grace Counseling Center

  • Professional Counselor
  • Lee's Summit, MO
  • NPI 1346417706

  Counseling

  NPD

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1235294018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1272 NE WINDSOR DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865594",
            "telephone_number": "816-246-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1272 NE WINDSOR DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865594",
            "telephone_number": "816-246-4465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TAMMY",
        "middle_name": "J",
        "credential": "LICENSED PSYCHOLOGIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "01757",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MO",
            "license": "01757",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MO",
            "license": "01757",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J O Johnson DO PC
• Courtney J Jack, APRN-BC
• Jackson County Eye Clinic Inc. (Eyecare Associates of Lee's Summit)
• Julie Jackson, PHARMD
• Melanie L Jackson, MOTR/L, CHT
• Tiffany Jackson, LPC
• Jacob a Laudie DDS LLC
• Jessica M Jacobs
• Rachel Jaggard
• Aniket Maheshkumar Jaimalani, M.D.

• Psychologist in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.