Active NPI
Rodney Jackson
- Rehabilitation Practitioner
- Los Angeles, CA
National Provider Identifier
1306981295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 5054 S Vermont Ave
Los Angeles, CA 90037-2946 - Phone
- (323) 373-2444
- NPI assigned
- Feb 20, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | Primary | ||
| Case Manager/Care Coordinator | 171M00000X |
Addresses
Primary practice location
5054 S Vermont Ave
Los Angeles, CA 90037-2946
Mailing address
1912 W 112TH St
Los Angeles, CA 90047-4739
Phone (323) 234-4445
Other practice location 1
5849 Crocker St Unit L
Los Angeles, CA 90003-1311
Phone (323) 234-4445
Other practice location 2
3031 S Vermont Ave
Los Angeles, CA 90007-3033
Phone (323) 373-2400
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellnest Emotional Health & Wellness | Current | Accepting new patients |
Locations
3031 S Vermont Ave
Los Angeles, CA 90007
Phone (323) 766-2345
5054 S Vermont Ave
Los Angeles, CA 90037
Phone (323) 373-2444
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Los Angeles, CA
- NPI 1801065438
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744675200000",
"number": "1306981295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1912 W 112TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900474739",
"telephone_number": "323-234-4445",
"fax_number": "323-234-4477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5054 S VERMONT AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900372946",
"telephone_number": "323-373-2444"
}
],
"practiceLocations": [
{
"address_1": "5849 Crocker St Unit L",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900031311",
"country_code": "US",
"telephone_number": "323-234-4445",
"fax_number": "323-234-4477",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3031 S Vermont Ave",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900073033",
"country_code": "US",
"telephone_number": "323-373-2400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "RODNEY",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-20",
"last_updated": "2025-04-15",
"certification_date": "2025-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.