Twyla Douglas Jackson I, RDN, CSO, LD

Primary specialty

Oncology Nutrition Registered DietitianTaxonomy code 133VN1301X

Practice address

Clinical Nutrition
1000 Johnson Ferry Rd NE
Atlanta, GA 30342

Phone

(404) 432-2916

NPI assigned

Mar 27, 2020

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

Other identifiers 1

Electronic endpoints 1

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": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1356978340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 SUMMIT VILLAGE LN",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300665962",
            "telephone_number": "404-432-2916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CLINICAL NUTRITION",
            "address_2": "1000 JOHNSON FERRY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "404-432-2916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TWYLA",
        "middle_name": "DOUGLAS",
        "name_suffix": "I",
        "credential": "RDN, CSO, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1301X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF GEORGIA LICENSE",
            "identifier": "LD001282",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "twyla.jackson@northside.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "Clinical Nutrition",
            "address_2": "1000 Johnson Ferry Rd NE",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Taylor Jackson, DC
• Taylor Simone Jackson
• Tiphani Jackson, PT, DPT, ATC
• Todd Jackson Jr., MD, MPH
• Troya Lusand Jackson, LMSW
• Tyler-Leah C Jackson, LCSW
• Vanessa Jane Jackson, MSW
• Vanna Manigault Jackson, MD FAAP
• Venita Joy Jackson, P.A.-C
• Victoria Jackson

• Registered Dietitian in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Registered Dietitian in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; 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.