Rita Michele Jackson

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

1010664 Issued in TX

Practice address

3529 Denton Hwy Ste D
Haltom City, TX 76117-3293

Phone

(817) 759-0707

Fax

(817) 759-0828

NPI assigned

Jun 20, 2023

Last updated

Jun 20, 2023By the provider in NPPES

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

State licenses

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1366127193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 ROSEDALE SPRINGS LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761348471",
            "telephone_number": "817-806-7032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3529 DENTON HWY STE D",
            "city": "HALTOM CITY",
            "state": "TX",
            "postal_code": "761173293",
            "telephone_number": "817-759-0707",
            "fax_number": "817-759-0828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "RITA",
        "middle_name": "MICHELE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "1010664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Industrial Med Management of Haltom City, LLC
• Melissa Lynn Inniss
• Innovative Medicare Solutions
• Integrated Federal Workers Center PLLC
• Christine B Jackson, S.L.P.
• Jasmeen Goyal Corp (Great Smiles)
• Jen-RX Inc (Jen Care Pharmacy)
• Jewel R Jenkins
• Claudia Elaine Jennings, COTA
• JLM Delesandri LLC (Best Medical Solutions)

• Licensed Vocational Nurse in Haltom City, TX
• Providers in Haltom City, TX by specialty
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.