Active NPI
Shanice B Jackson
- Nurse's Aide
- Omaha, NE
National Provider Identifier
1407651243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- Practice address
- 4601 S 50TH St
Omaha, NE 68117-1355 - Phone
- (402) 718-6700
- NPI assigned
- Feb 17, 2025
- Last updated
- Feb 17, 2025
- 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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | Primary |
Addresses
Primary practice location
4601 S 50TH St
Omaha, NE 68117-1355
Mailing address
7935 N 154TH Ave
Bennington, NE 68007-1819
Phone (402) 250-9338
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| P-31 Services, LLC | Nurse's Aide | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739750400000",
"number": "1407651243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7935 N 154TH AVE",
"city": "BENNINGTON",
"state": "NE",
"postal_code": "680071819",
"telephone_number": "402-250-9338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4601 S 50TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681171355",
"telephone_number": "402-718-6700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "SHANICE",
"middle_name": "B",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-02-17",
"last_updated": "2025-02-17",
"certification_date": "2025-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.