Tayanna I Jackson

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

2490 Lee Blvd Ste 103
Cleveland Heights, OH 44118-1255

Phone

(216) 835-5212

NPI assigned

Jul 18, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Life Solutions South

  • Substance Abuse Rehabilitation Facility
  • Cleveland, OH
  • NPI 1558820498

  Multi-Specialty

  NPD (past)
• Life Solutions South

  • Community/Behavioral Health Agency
  • Cleveland, OH
  • NPI 1578962957
  NPD (past)

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1245716646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 LEE BLVD STE 103",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441181255",
            "telephone_number": "216-835-5212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 LEE BLVD STE 103",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441181255",
            "telephone_number": "216-835-5212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TAYANNA",
        "middle_name": "I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Itreatment & Recovery Services, Inc
• Itreatment & Recovery Services, Inc
• J and J Counseling and Consultation, LLP
• Deanna Jackson, RN
• Jill E Jackson, MA, CCC-SLP
• Kashara Anne Jacobs, RN
• Coleman James
• Evelyn Clair James, N.P.
• Anna J. Janicki, M.D.
• Amanda Jaros, PHARMD

• Community Health Worker in Cleveland Heights, OH
• Providers in Cleveland Heights, OH by specialty
• Community Health Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.