Active NPI
Cynthia Jackson, R.N. CDE
- Diabetes Educator Registered Nurse
- Dayton, OH
National Provider Identifier
1376784181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diabetes Educator Registered Nurse
- License
- RN165448
- Practice address
- 1222 S Patterson Blvd
Suite 210
Dayton, OH 45402-2684 - Phone
- (937) 208-9090
- NPI assigned
- Mar 9, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Diabetes Educator Registered Nurse | 163WD0400X | RN165448 | OH | Primary |
Addresses
Primary practice location
1222 S Patterson Blvd
Suite 210
Dayton, OH 45402-2684
Mailing address
1222 S. Patterson Blvd.
Suite 201
Dayton, OH 45402
Phone (937) 208-9090
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN165448 | OH | MD | Diabetes Educator Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236556800000",
"number": "1376784181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1222 S. PATTERSON BLVD.",
"address_2": "SUITE 201",
"city": "DAYTON",
"state": "OH",
"postal_code": "45402",
"telephone_number": "937-208-9090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1222 S PATTERSON BLVD",
"address_2": "SUITE 210",
"city": "DAYTON",
"state": "OH",
"postal_code": "454022684",
"telephone_number": "937-208-9090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CYNTHIA",
"name_prefix": "Mrs.",
"credential": "R.N. CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-09",
"last_updated": "2009-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "163WD0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Diabetes Educator",
"state": "OH",
"license": "RN165448",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.