Stephen Jackson, RDCS, RVT

Primary specialty

Sonography Specialist/Technologist CardiovascularTaxonomy code 246XS1301X

License

105942 Issued in FL

Practice address

2577 Sawgrass Lake CT
Cape Coral, FL 33909-2935

Phone

(202) 277-1063

NPI assigned

Mar 11, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1426032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426032000000",
    "number": "1275926503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2577 SAWGRASS LAKE CT",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339092935",
            "telephone_number": "202-277-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2577 SAWGRASS LAKE CT",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339092935",
            "telephone_number": "202-277-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "STEPHEN",
        "credential": "RDCS, RVT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-11",
        "last_updated": "2015-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246XC2903X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist Cardiovascular, Vascular Specialist",
            "state": "FL",
            "license": "105942",
            "primary": false
        },
        {
            "code": "246XS1301X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist Cardiovascular, Sonography",
            "state": "FL",
            "license": "105942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maricela Izquierdo Hernandez
• Merlin Izquierdo Perez
• Lizmary Izquierdo
• J Lopez Hearing AIDS Inc.
• Amy Michelle Jablonski, PA-C
• Aris Nicholas Jacob, MD
• Thomas P Jacob, MD
• George B Jacobs, MD
• Ellen M Jacobsen
• Ronald Irving Jacoby, M.D.

• Sonography Specialist/Technologist Cardiovascular in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Sonography Specialist/Technologist Cardiovascular in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; 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.