Shirley Jean Jackson, RN

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

Practice address

21 North Atwood Ave
Janesville, WI 53648

Phone

(608) 931-4477

NPI assigned

Jan 10, 2007

Last updated

Mar 19, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205884800000",
    "number": "1538218292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13236 WYNSTONE WAY",
            "city": "ROCKTON",
            "state": "IL",
            "postal_code": "610723254",
            "telephone_number": "608-931-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 NORTH ATWOOD AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "53648",
            "telephone_number": "608-931-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHIRLEY",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2008-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39916200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rajeshwari N Iyer, MPT
• J&T Transit
• Amie Jabang, APNP-FNP
• Jessica L Jach, LCSW, MSW
• Bradley Jackson
• Brenda Lee Jacobs, RPH
• Julie A Jacobs, PH.D.
• Stephen Christiaan Jacobs, MD
• Fahim Haider Jafary, M.D.
• Don Richard Janczak, PHARMD BCPS

• Home Health Registered Nurse in Janesville, WI
• Providers in Janesville, WI by specialty
• Home Health Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; 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.