Tameka Latoya Jackson -Dyer, IBCLC, CHW

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

L-122778

Practice address

18983 Edinborough Rd
Detroit, MI 48219-2825

Phone

(248) 694-4402

NPI assigned

Jan 18, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Tameka Latoya Jackson-Smith Former name

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": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1497229751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19171",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482190171",
            "telephone_number": "248-694-4402",
            "fax_number": "313-731-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18983 EDINBOROUGH RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482192825",
            "telephone_number": "248-694-4402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON -DYER",
        "first_name": "TAMEKA",
        "middle_name": "LATOYA",
        "credential": "IBCLC, CHW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-18",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": "L-122778",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMEKA",
            "last_name": "JACKSON-SMITH",
            "middle_name": "LATOYA",
            "credential": "IBCLC, CHW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chaun Rene Jack
• Jackies Guardian Angels LLC.
• Catherine Brock Jackman, ACNS-BC
• Latoya T Jackosn, COUNSELOR
• Mackenzie Jacks, PA-C
• Phazhe Jackson Dorr
• Jackson Health Services
• Jackson Health Services
• Taylour D Jackson Knight
• Linda Rose Jackson-Carter, RN, BSN

• Lactation Consultant (Non-RN) in Detroit, MI
• Providers in Detroit, MI by specialty
• Lactation Consultant (Non-RN) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.