Brittany Jackson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

2013001693 Issued in MO

Practice address

1639 Bruce Smith Pkwy
West Plains, MO 65775-7691

Phone

(417) 257-1833

Fax

(417) 256-0488

NPI assigned

Dec 17, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• BHG Lxxiv, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • West Plains, MO
  • NPI 1710698055
  NPD (past)
• BHG Xxviii, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • West Plains, MO
  • NPI 1164833877
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1467923458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 BRYAN ST",
            "city": "WILLOW SPRINGS",
            "state": "MO",
            "postal_code": "657933475",
            "telephone_number": "417-505-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1639 BRUCE SMITH PKWY",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657757691",
            "telephone_number": "417-257-1833",
            "fax_number": "417-256-0488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRITTANY",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "2013001693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Ingersoll, RD
• Tiffany Iott
• Phool Iqbal
• Brian Lee Israel, MD
• Sathish Kumar Itikyala, M.D.
• Christy Lynn Jackson, LPC
• Tara Naomi Jackson, DO
• Ashley Jacobson
• James Scott Wiley
• Sydney Jennings, COTA/L

• Licensed Practical Nurse in West Plains, MO
• Providers in West Plains, MO by specialty
• Licensed Practical Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.