Robin M Jackson, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

21380 Issued in CA

Practice address

1782 W Hammer LN # 3
Stockton, CA 95209-2922

Phone

(916) 296-7909

NPI assigned

Dec 13, 2011

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Seahurst Chiropractic Clinic Inc.

  • Chiropractor
  • Burien, WA
  • NPI 1316146319
  NPD
• Pacific Northwest Urogynecology PLLC

  • Specialist
  • Arlington, WA
  • NPI 1205015112
  NPD (past)

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

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338336000000",
    "number": "1508134982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1782 W HAMMER LN # 3",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952092922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1782 W HAMMER LN # 3",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952092922",
            "telephone_number": "916-296-7909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ROBIN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-13",
        "last_updated": "2012-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "21380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laseanna Jackson
• Lauren Victoria Jackson
• Lela Keiana Jackson
• Lenley Bradford Jackson, M.D.
• Phannong Jackson, MFTI
• Ronesha Jackson
• Shanee Domonique Jackson
• Steve Ray Jackson
• Steven Jackson
• Tam-Me Jackson

• Nurse Practitioner in Stockton, CA
• Providers in Stockton, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.