Savannah Jackson, MSN, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26443 Issued in SC

Practice address

10175 Little Patuxent Pkwy
Columbia, MD 21044-2655

Phone

(800) 561-0861

NPI assigned

Jul 20, 2022

Sex

Female

Sole proprietor

No

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

Credentials

Master of Science - Nursing

State licenses

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696032000000",
    "number": "1336874643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10175 LITTLE PATUXENT PKWY",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10175 LITTLE PATUXENT PKWY",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442655",
            "telephone_number": "800-561-0861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 E Main St",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "SC",
            "postal_code": "297091717",
            "country_code": "US",
            "telephone_number": "843-623-7125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SAVANNAH",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-20",
        "last_updated": "2023-09-30",
        "certification_date": "2023-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "26443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariah Jackson
• Marquan Jackson, LLMSW
• Mercy Preethi Jackson, M.D.
• Mia L Jackson
• Michquel Jackson
• Stephanie Ann Jackson, PHARMD
• Toreh Alysandra Jackson, RBT
• Wendy M. Jackson, RPH
• Yvonne Jackson
• Jacob Cherian MD LLC

• Family Nurse Practitioner in Columbia, MD
• Providers in Columbia, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2023; 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.