Michelle Ann Jackson

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

7124 Diving Petrels PL
7124 Diving Petrels PL
North Las Vegas, NV 89084-2353

Phone

(702) 772-0768

NPI assigned

Mar 31, 2011

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

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

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1285923185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7124 DIVING PETRELS PL",
            "address_2": "7124 DIVING PETRELS PL",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890842353",
            "telephone_number": "702-772-0768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7124 DIVING PETRELS PL",
            "address_2": "7124 DIVING PETRELS PL",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890842353",
            "telephone_number": "702-772-0768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-31",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lashonda Jackson
• Latisha Evette Jackson, BS
• Lira Jackson
• Marcus Jackson
• Mario Michael Jackson, D.D.S.
• Michelle Laray Jackson, CPC
• Patsy Jackson
• Phelton Gerrard Jackson, N/A
• Rebekah Jackson
• Robert Jackson

• Rehabilitation Practitioner in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Rehabilitation Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; 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.