Sarah Jackson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.0036875 Issued in OH

Practice address

721 Miami Chapel Rd
Dayton, OH 45417-4650

Phone

(937) 281-6800

NPI assigned

Jun 29, 2024

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

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Five Rivers Health Centers

  • Family Medicine Physician
  • Dayton, OH
  • NPI 1669143061
  Medicare reassignment
• Five Rivers Health Centers

  • Family Medicine Physician
  • Dayton, OH
  • NPI 1053600775
  NPD
• Five Rivers Health Centers

  • Family Medicine Physician
  • Xenia, OH
  • NPI 1083501415
  NPD

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

{
    "created_epoch": "1719619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719619200000",
    "number": "1275378325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 MIAMI CHAPEL RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454174650",
            "telephone_number": "937-281-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 MIAMI CHAPEL RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454174650",
            "telephone_number": "937-281-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-29",
        "last_updated": "2024-06-29",
        "certification_date": "2024-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0036875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole R Jackson, CNP, ACNP-BC
• Nikkita T Jackson, LISW
• Parita Jackson
• Robert Jackson
• Sakisha Vernee' Jackson, LPN
• Shatonne Dianne Jackson, LPN
• Shelby L Jackson, A.A.S / QMHS
• Shelia M Jackson
• Tabiah Samone Jackson
• Thia R Jackson

• Family Nurse Practitioner in Dayton, OH
• Providers in Dayton, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.