Active NPI
Andrea Bessie Jackson
- Case Manager/Care Coordinator
- Oklahoma City, OK
National Provider Identifier
1306140876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 6030 S May Ave Apt 451
Oklahoma City, OK 73159-1410 - Phone
- (405) 684-9976
- NPI assigned
- Dec 27, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
6030 S May Ave Apt 451
Oklahoma City, OK 73159-1410
Mailing address
6030 S May Ave Apt 451
Oklahoma City, OK 73159-1410
Phone (405) 684-9976
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293408000000",
"number": "1306140876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6030 S MAY AVE APT 451",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731591410",
"telephone_number": "405-684-9976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6030 S MAY AVE APT 451",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731591410",
"telephone_number": "405-684-9976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "ANDREA",
"middle_name": "BESSIE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-27",
"last_updated": "2010-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.