Linda Jackson

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

G01059040 Issued in NE

Practice address

1813 N 73Rd St
Omaha, NE 68114-1905

Phone

(402) 557-8583

NPI assigned

Apr 28, 2025

Sex

Female

Sole proprietor

Yes

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

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.

• Developmental Disability Center of Iowa LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Council Bluffs, IA
  • NPI 1588212179

  Community Based Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD (past)

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

{
    "created_epoch": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1265220628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1813 N 73RD ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681141905",
            "telephone_number": "402-557-8583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 N 73RD ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681141905",
            "telephone_number": "402-557-8583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1805 N 73rd St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681141905",
            "country_code": "US",
            "telephone_number": "402-557-6583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LINDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NE",
            "license": "G01059040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larrell Lee Jackson
• Latanya Jackson
• Latisha Jackson
• Lauren Jackson
• Leanne Lynn Jackson
• Loreal Lanique Jackson
• Lynette M Jackson
• Lynn Jackson
• Markisha S Jackson
• Marvinette Jackson

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Omaha, NE
• Providers in Omaha, NE by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.