Active NPI
Cynthia L Jackson, ARNP
- Family Nurse Practitioner
- Leavenworth, KS
National Provider Identifier
1427007269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1346066122
- Practice address
- 4101 S 4TH St
Leavenworth, KS 66048-5014 - Phone
- (913) 682-2000
- Fax
- (913) 758-4119
- NPI assigned
- May 9, 2006
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1346066122 | KS | Primary |
Addresses
Primary practice location
4101 S 4TH St
Leavenworth, KS 66048-5014
Mailing address
4101 S 4TH St
Leavenworth, KS 66048-5014
Phone (913) 682-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1346066122 | KS | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184544000000",
"number": "1427007269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4101 S 4TH ST",
"city": "LEAVENWORTH",
"state": "KS",
"postal_code": "660485014",
"telephone_number": "913-682-2000",
"fax_number": "913-758-4119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101 S 4TH ST",
"city": "LEAVENWORTH",
"state": "KS",
"postal_code": "660485014",
"telephone_number": "913-682-2000",
"fax_number": "913-758-4119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CYNTHIA",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-09",
"last_updated": "2007-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KS",
"license": "1346066122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leavenworth, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.