Active NPI
Janet Leah Jackson
- Registered Nurse
- Myrtle Beach, SC
National Provider Identifier
1417867169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 0001213767
- Practice address
- 412 Plover LN
Myrtle Beach, SC 29588-6569 - Phone
- (757) 816-6855
- NPI assigned
- Sep 8, 2026
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 0001213767 | VA | Primary |
Addresses
Primary practice location
412 Plover LN
Myrtle Beach, SC 29588-6569
Mailing address
412 Plover LN
Myrtle Beach, SC 29588-6569
Phone (757) 816-6855
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": "1788825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788825600000",
"number": "1417867169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "412 PLOVER LN",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295886569",
"telephone_number": "757-816-6855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "412 PLOVER LN",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295886569",
"telephone_number": "757-816-6855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JANET",
"middle_name": "LEAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-09-08",
"last_updated": "2026-09-08",
"certification_date": "2026-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "VA",
"license": "0001213767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.