Active NPI
Becky J Jackson, RN
- Obstetrics Physician
- Murray, UT
National Provider Identifier
1316459035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics Physician
- License
- 208109-3102
- Practice address
- 5121 S Cottonwood St
Murray, UT 84107-5701 - Phone
- (801) 507-7673
- NPI assigned
- Nov 3, 2017
- 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 |
|---|---|---|---|---|
| Obstetrics Physician | 207VX0000X | 208109-3102 | UT | Primary |
Addresses
Primary practice location
5121 S Cottonwood St
Murray, UT 84107-5701
Mailing address
4778 W Els CT
South Jordan, UT 84009-1215
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 208109-3102 | UT | MD | Obstetrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509667200000",
"number": "1316459035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4778 W ELS CT",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840091215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5121 S COTTONWOOD ST",
"city": "MURRAY",
"state": "UT",
"postal_code": "841075701",
"telephone_number": "801-507-7673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "BECKY",
"middle_name": "J",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-03",
"last_updated": "2017-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "207VX0000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Obstetrics",
"state": "UT",
"license": "208109-3102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Murray, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.