Individual provider Active NPI

Ma'Kayla Chree Jackson

  • Registered Nurse
  • Detroit, MI
National Provider Identifier
1396667846
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704448060 Issued in MI
Practice address
11000 W McNichols Rd Ste 3231306
Detroit, MI 48221-2357
Phone
(419) 280-9930
NPI assigned
Jul 27, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704448060 MI Primary

Addresses

Primary practice location

11000 W McNichols Rd Ste 3231306
Detroit, MI 48221-2357

Mailing address

11000 W McNichols Rd Ste 3231306
Detroit, MI 48221-2357
Phone (419) 280-9930

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": "1785110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1396667846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11000 W MCNICHOLS RD STE 3231306",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212357",
            "telephone_number": "419-280-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11000 W MCNICHOLS RD STE 3231306",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212357",
            "telephone_number": "419-280-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MA'KAYLA",
        "middle_name": "CHREE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-07-27",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704448060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; 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.