Active NPI
Tameka Peta-Gay Jackson, D.O.
- Neurological Surgery Physician
- Clinton Township, MI
National Provider Identifier
1265755490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 5101018465
- Practice address
- 15855 19 Mile Rd
Clinton Township, MI 48038-3504 - Phone
- (586) 263-2950
- NPI assigned
- Mar 2, 2010
- 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 |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 5101018465 | MI | Primary |
Addresses
Primary practice location
15855 19 Mile Rd
Clinton Township, MI 48038-3504
Mailing address
15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2950
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
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101018465 | MI | MD | Neurological Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267488000000",
"number": "1265755490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15855 19 MILE RD",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480383504",
"telephone_number": "586-263-2950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15855 19 MILE RD",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480383504",
"telephone_number": "586-263-2950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "TAMEKA",
"middle_name": "PETA-GAY",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-02",
"last_updated": "2010-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "MI",
"license": "5101018465",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.