Active NPI
Callie Jo Jackson, LMSW
- Social Worker
- Muscatine, IA
National Provider Identifier
1487387445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 112708
- Practice address
- 1518 Mulberry Ave
Muscatine, IA 52761-3433 - Phone
- (563) 264-9240
- NPI assigned
- Jul 7, 2022
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 112708 | IA | Primary |
Addresses
Primary practice location
1518 Mulberry Ave
Muscatine, IA 52761-3433
Mailing address
1518 Mulberry Ave
Muscatine, IA 52761-3433
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 |
|---|---|---|---|
| 112708 | IA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657152000000",
"number": "1487387445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1518 MULBERRY AVE",
"city": "MUSCATINE",
"state": "IA",
"postal_code": "527613433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1518 MULBERRY AVE",
"city": "MUSCATINE",
"state": "IA",
"postal_code": "527613433",
"telephone_number": "563-264-9240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CALLIE",
"middle_name": "JO",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-07",
"last_updated": "2022-07-07",
"certification_date": "2022-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IA",
"license": "112708",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muscatine, IA
- Iowa Physicians Clinic Medical Foundation (UnityPoint Clinic - Family Medicine - North Port)
- Iowa Physicians Clinic Medical Foundation
- Melissa Irmen, CNM
- Ana Isaacson, LMSW
- Gholam Jabbari, M.D.
- Maitreyi Janarthanan, MD
- Emma Janecek
- Meika Jensen, LMSW
- Jarod William Johnson, D.D.S.
- Madison Nicole Johnson
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.