Active NPI
Sarah Jackson
- Registered Nurse
- Athens, GA
National Provider Identifier
1518368505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 240679
- Practice address
- 195 Miles St
Athens, GA 30601-1820 - Phone
- (706) 369-6310
- NPI assigned
- Sep 9, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 240679 | GA | Primary |
Addresses
Primary practice location
195 Miles St
Athens, GA 30601-1820
Mailing address
4704 Melbourne TRL
Flowery Branch, GA 30542-6419
Phone (678) 617-0745
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 |
|---|---|---|---|
| 240679 | GA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410220800000",
"number": "1518368505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4704 MELBOURNE TRL",
"city": "FLOWERY BRANCH",
"state": "GA",
"postal_code": "305426419",
"telephone_number": "678-617-0745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "195 MILES ST",
"city": "ATHENS",
"state": "GA",
"postal_code": "306011820",
"telephone_number": "706-369-6310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "SARAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-09",
"last_updated": "2014-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "GA",
"license": "240679",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Athens, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.