Sarah Jackson

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

790746 Issued in NY

Practice address

622 3Rd Ave FL 39
New York, NY 10017-6711

Phone

(212) 490-7400

NPI assigned

Dec 10, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1639094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1255090809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "896 TROY ST",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110035004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 3RD AVE FL 39",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176711",
            "telephone_number": "212-490-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-10",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "790746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reesha Jackson
• Rishona Jackson, M.S. ED
• Roberta Marie Jackson, LCSW CASAC-II
• Ruslana Jackson, NP
• Samuel Jackson
• Sarah Mackenzie Jackson, MD
• Shawnmarie Loreen Jackson, NP
• Sherry Jackson, M.D.
• Susan Jackson, LMSW
• Tanaisha Jackson

• Registered Nurse in New York, NY
• Providers in New York, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.