Active NPI
Erica Adanna Jackson, MS, RD
- Registered Dietitian
- Bronx, NY
National Provider Identifier
1235982356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86297010
- Practice address
- 130 W Kingsbridge Rd
Bronx, NY 10468-3904 - Phone
- (718) 584-9000
- NPI assigned
- Apr 9, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86297010 | NY | Primary |
Addresses
Primary practice location
130 W Kingsbridge Rd
Bronx, NY 10468-3904
Mailing address
62 Midland Ave
Yonkers, NY 10705-2733
Phone (845) 642-6339
Other practice location 1
62 Midland Ave
Yonkers, NY 10705-2733
Phone (845) 642-6339
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86297010 | NY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fig Health, Inc | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712620800000",
"number": "1235982356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 MIDLAND AVE",
"city": "YONKERS",
"state": "NY",
"postal_code": "107052733",
"telephone_number": "845-642-6339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 W KINGSBRIDGE RD",
"city": "BRONX",
"state": "NY",
"postal_code": "104683904",
"telephone_number": "718-584-9000"
}
],
"practiceLocations": [
{
"address_1": "62 Midland Ave",
"address_purpose": "LOCATION",
"city": "Yonkers",
"state": "NY",
"postal_code": "107052733",
"country_code": "US",
"telephone_number": "845-642-6339",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "ERICA",
"middle_name": "ADANNA",
"credential": "MS, RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-09",
"last_updated": "2024-04-09",
"certification_date": "2024-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "86297010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.