Active NPI
Cameron Lauren Jackson
- Community Health Worker
- Philadelphia, PA
National Provider Identifier
1417865809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 1916 E Clearfield St
Philadelphia, PA 19134-3106 - Phone
- (215) 607-1073
- NPI assigned
- Aug 28, 2026
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | PA | Primary |
Addresses
Primary practice location
1916 E Clearfield St
Philadelphia, PA 19134-3106
Mailing address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787875200000",
"number": "1417865809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191405103",
"telephone_number": "215-707-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1916 E CLEARFIELD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191343106",
"telephone_number": "215-607-1073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CAMERON",
"middle_name": "LAUREN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-08-28",
"last_updated": "2026-08-28",
"certification_date": "2026-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "PA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.