Active NPI
Nyasia Jackson
- Clinical Social Worker
- Stuart, FL
National Provider Identifier
1366189680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 7108 S Kanner Hwy
Stuart, FL 34997-7462 - Phone
- (855) 832-6727
- NPI assigned
- May 18, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
7108 S Kanner Hwy
Stuart, FL 34997-7462
Mailing address
3697 Tyson Green Way
Tallahassee, FL 32310-4963
Phone (757) 339-4981
Other practice location 1
3697 Tyson Green Way
Tallahassee, FL 32310-4963
Phone (757) 339-4981
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652832000000",
"number": "1366189680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3697 TYSON GREEN WAY",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323104963",
"telephone_number": "757-339-4981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7108 S KANNER HWY",
"city": "STUART",
"state": "FL",
"postal_code": "349977462",
"telephone_number": "855-832-6727"
}
],
"practiceLocations": [
{
"address_1": "3697 Tyson Green Way",
"address_purpose": "LOCATION",
"city": "Tallahassee",
"state": "FL",
"postal_code": "323104963",
"country_code": "US",
"telephone_number": "757-339-4981",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "NYASIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-18",
"last_updated": "2022-05-18",
"certification_date": "2022-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stuart, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.