Active NPI
Caroline D Jackson
- Peer Specialist
- Cincinnati, OH
National Provider Identifier
1275277352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- APS.006061
- Practice address
- 1501 Madison Rd
Cincinnati, OH 45206 - Phone
- (513) 354-5200
- NPI assigned
- Apr 25, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | OH | ||
| Peer Specialist | 175T00000X | APS.006061 | OH | Primary |
Addresses
Primary practice location
1501 Madison Rd
Cincinnati, OH 45206
Mailing address
1501 Madison Rd
Cincinnati, OH 45206
Phone (513) 354-5200
Other practice location 1
1088 Wasserman Way
Batavia, OH 45103
Phone (513) 735-8100
Other practice location 2
4531 Reading Rd
Cincinnati, OH 45229-1229
Phone (513) 281-2273
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APS.006061 | OH | MD | Peer Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clermont Recovery Center, Inc. | 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.
-
- Public Health or Welfare Agency
- Batavia, OH
- NPI 1043277759
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739836800000",
"number": "1275277352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 MADISON RD",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "45206",
"telephone_number": "513-354-5200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 MADISON RD",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "45206",
"telephone_number": "513-354-5200"
}
],
"practiceLocations": [
{
"address_1": "1088 WASSERMAN WAY",
"address_purpose": "LOCATION",
"city": "BATAVIA",
"state": "OH",
"postal_code": "45103",
"country_code": "US",
"telephone_number": "513-735-8100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4531 Reading Rd",
"address_purpose": "LOCATION",
"city": "Cincinnati",
"state": "OH",
"postal_code": "452291229",
"country_code": "US",
"telephone_number": "513-281-2273",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "CAROLINE",
"middle_name": "D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-25",
"last_updated": "2025-02-18",
"certification_date": "2025-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OH",
"license": "APS.006061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.