Active NPI
Kelly Elaine Jackson, MS, CGC
- Genetic Counselor (M.S.)
- Louisville, KY
National Provider Identifier
1427047380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Genetic Counselor (M.S.)
- License
- GC008
- Practice address
- 411 E Chestnut St
Louisville, KY 40202 - Phone
- (502) 588-0850
- Fax
- (502) 588-0721
- NPI assigned
- Oct 13, 2005
- 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 |
|---|---|---|---|---|
| Genetic Counselor (M.S.) | 170300000X | GC008 | KY | Primary |
Addresses
Primary practice location
411 E Chestnut St
Louisville, KY 40202
Mailing address
PO Box 909
Louisville, KY 40201-0909
Phone (502) 588-0850
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kjackson40716@direct.nortonhealthcare.org | ||
| FHIR URL | https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/ |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| GC008 | KY | MD | Genetic Counselor (M.S.) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653350400000",
"number": "1427047380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 909",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402010909",
"telephone_number": "502-588-0850",
"fax_number": "502-588-0721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 E CHESTNUT ST",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "40202",
"telephone_number": "502-588-0850",
"fax_number": "502-588-0721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "KELLY",
"middle_name": "ELAINE",
"name_prefix": "Miss",
"credential": "MS, CGC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-13",
"last_updated": "2022-05-24",
"certification_date": "2022-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "170300000X",
"taxonomy_group": "",
"desc": "Genetic Counselor, MS",
"state": "KY",
"license": "GC008",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kjackson40716@direct.nortonhealthcare.org",
"affiliation": "N",
"address_1": "411 E Chestnut St",
"city": "Louisville",
"state": "KY",
"country_code": "US",
"postal_code": "40202",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "411 E Chestnut St",
"city": "Louisville",
"state": "KY",
"country_code": "US",
"postal_code": "40202",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.