Kacie Lee Jackson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

312 N Van Buren St
Enid, OK 73703-4500

Phone

(888) 573-7792

NPI assigned

Aug 30, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Millennium Community Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Enid, OK
  • NPI 1013309616
  NPD (past)

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1548742224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 E DOGWOOD DR",
            "city": "POND CREEK",
            "state": "OK",
            "postal_code": "737669788",
            "telephone_number": "405-570-7523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 N VAN BUREN ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737034500",
            "telephone_number": "888-573-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KACIE",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Dawn Iverson
• J.M.Dilling,Jr.,M.D.Jr.,Inc
• Annietha Jack
• Angela Michelle Jackson, MCP, BHRS
• Gisele D Jackson, M.ED
• Michael S Jackson, MD
• Toni Dawn Jackson, DNP, APRN, NP-C
• Leslie Gail Jager, PSRS
• Jennifer Rae Jaggers
• James P. Worrell M.D., P.C.

• Case Manager/Care Coordinator in Enid, OK
• Providers in Enid, OK by specialty
• Case Manager/Care Coordinator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.