Carlos Jackson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

4342 Harrison Ave Ste 1
Cincinnati, OH 45211-3390

Phone

(513) 574-1500

NPI assigned

May 13, 2021

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1477127678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3816 DUNLOE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452132302",
            "telephone_number": "513-834-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4342 HARRISON AVE STE 1",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452113390",
            "telephone_number": "513-574-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CARLOS",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-13",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Kimball Jackson, MD, MPH
• Arion Elysse Jackson
• Brandon Jackson
• Burnette Jackson, RN
• Carley M Jackson, PT, DPT
• Caroline D Jackson
• Chanda Jackson
• Chenell Jackson, LPN
• Christen Lynn Jackson
• Ciara Monet Jackson, DSP, STNA

• Case Manager/Care Coordinator in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Case Manager/Care Coordinator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; 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.