Active NPI
David Dawson Jackson
- Social Worker
- Akron, OH
National Provider Identifier
1467809574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.0005654
- Practice address
- 10 Penfield Ave
Akron, OH 44310-2912 - Phone
- (330) 762-6110
- Fax
- (330) 253-6810
- NPI assigned
- May 18, 2016
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | S.0005654 | OH | Primary |
Addresses
Primary practice location
10 Penfield Ave
Akron, OH 44310-2912
Mailing address
340 S Broadway St
Akron, OH 44308-1529
Phone (330) 253-3100
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.0005654 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463529600000",
"number": "1467809574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 S BROADWAY ST",
"city": "AKRON",
"state": "OH",
"postal_code": "443081529",
"telephone_number": "330-253-3100",
"fax_number": "330-376-8002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 PENFIELD AVE",
"city": "AKRON",
"state": "OH",
"postal_code": "443102912",
"telephone_number": "330-762-6110",
"fax_number": "330-253-6810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "DAVID",
"middle_name": "DAWSON",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-18",
"last_updated": "2016-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.0005654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Akron, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.