Tomiah Jackson

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

0021599 Issued in WI

Practice address

4057 N Mayfair Rd
Wauwatosa, WI 53222-1101

Phone

(414) 788-1084

Fax

(862) 263-7319

NPI assigned

Nov 5, 2025

Last updated

Nov 5, 2025By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kimps Adult Day Center, LLC

  • Adult Day Care Clinic/Center
  • Milwaukee, WI
  • NPI 1043043904
  NPD Authorized official

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

{
    "created_epoch": "1762300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1275403388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4057 N MAYFAIR RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532221101",
            "telephone_number": "414-788-1084",
            "fax_number": "862-263-7319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4057 N MAYFAIR RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532221101",
            "telephone_number": "414-788-1084",
            "fax_number": "862-263-7319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TOMIAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-05",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "WI",
            "license": "0021599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter J Isely, LCSW
• Alicia Ivory, MD
• J.L. Mackman DDS
• Danita A Jackson, LPC-IT
• Denis Ian Jackson, PH.D.
• Emily E Jacobs, PA-C
• Anna Jacques
• Tanya Jahr
• Barbara James
• Sara Renee James, M.S., LMFT

• Adult Day Care Clinic/Center in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Adult Day Care Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.