Lori Jackson

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

400989351009 Issued in OH

Practice address

2800 Tusky Valley Rd NE
Mineral City, OH 44656-9691

Phone

(330) 324-2840

NPI assigned

Jan 31, 2018

Last updated

Jan 31, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1477051845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 482",
            "city": "MINERAL CITY",
            "state": "OH",
            "postal_code": "446560482",
            "telephone_number": "330-324-2840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 TUSKY VALLEY RD NE",
            "city": "MINERAL CITY",
            "state": "OH",
            "postal_code": "446569691",
            "telephone_number": "330-324-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LORI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-31",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "OH",
            "license": "400989351009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0241295",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jannette Marie Devine, RN
• Leonard F Dyko, PA-C
• Kasey Jo Fishley, AGNP-C
• Heiwa Center
• Heiwa Center - North
• Becky Kay Krisher, M.A., CCC-SLP
• Mineral-Sandy Ambulance District
• Allyson Moser, LMT
• Aaron Weber, LMT
• Cherie Weber, LMT

• Home Health Aide in Mineral City, OH
• Providers in Mineral City, OH by specialty
• Home Health Aide in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.