Nicole S Jackson, Family NP,PC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

NICOLE S JACKSON, FAMILY NP,PC

Practice address

1010 Kendal Way
Sleepy Hollow, NY 10591-1055

Phone

(914) 922-1027

Fax

(914) 922-1158

NPI assigned

Feb 13, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nicole S Jackson, FNP

Title

FNP-Owner of PC

Phone

(914) 739-2245

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• nicole s jackson, family np, pc Doing business as

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1366610271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 COVENTRY CT",
            "city": "CROTON ON HUDSON",
            "state": "NY",
            "postal_code": "105201001",
            "telephone_number": "914-739-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 KENDAL WAY",
            "city": "SLEEPY HOLLOW",
            "state": "NY",
            "postal_code": "105911055",
            "telephone_number": "914-922-1027",
            "fax_number": "914-922-1158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE S JACKSON, FAMILY NP,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-13",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "FNP-OWNER OF PC",
        "authorized_official_telephone_number": "914-739-2245",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1831385848",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02733026",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "nicole s jackson, family np, pc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Nurse Practitioner in Sleepy Hollow, NY
• Providers in Sleepy Hollow, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; 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.