Kmjackson

Primary specialty

Home Health AideTaxonomy code 374U00000X

Legal business name

KMJACKSON

Practice address

2020 Brownlee Ave
Youngstown, OH 44514-1016

Phone

(330) 402-9641

NPI assigned

Sep 20, 2021

Organization subpart

No

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

Authorized official

Name

Kathryn JacksonNPI 1073119525

Title

Owner

Phone

(330) 402-9641

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• KMJackson Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kathryn M Jackson

  • Home Health Aide
  • Youngstown, OH
  • NPI 1073119525
  NPD Authorized official

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1235809237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 BROWNLEE AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445141016",
            "telephone_number": "330-402-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 BROWNLEE AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445141016",
            "telephone_number": "330-402-9641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KMJACKSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-20",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-402-9641"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235809237",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1073119525",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KMJackson",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KMJackson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madison Marissa Klingman, LISW
• Erin Klink
• Karlee Lynn Kluchar
• Jessica Lynn Klumph, RN
• Jason Kmentt
• Knabe, Two Sister'S Homes LLC
• Knapp Center for Childhood Development
• Julie A Knapp, PHD, BCBA-D,COBA
• Justine Knauf
• Kearstin L Knecht, MD

• All providers in Youngstown, OH
• Home Health Aide in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; 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.