Active NPI
Sylina Jackson
- Community Health Worker
- Juneau, AK
National Provider Identifier
1477213239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 10801 Black Bear Rd
Juneau, AK 99801-8783 - Phone
- (907) 789-7610
- NPI assigned
- Dec 21, 2021
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
10801 Black Bear Rd
Juneau, AK 99801-8783
Mailing address
8527 Jennifer Dr Apt 3
Juneau, AK 99801-9094
Phone (907) 209-1202
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1640044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640044800000",
"number": "1477213239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8527 JENNIFER DR APT 3",
"city": "JUNEAU",
"state": "AK",
"postal_code": "998019094",
"telephone_number": "907-209-1202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10801 BLACK BEAR RD",
"city": "JUNEAU",
"state": "AK",
"postal_code": "998018783",
"telephone_number": "907-789-7610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "SYLINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-21",
"last_updated": "2021-12-21",
"certification_date": "2021-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Juneau, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.