Active NPI
Michele N Jackson
- Licensed Practical Nurse
- Rochester, NY
National Provider Identifier
1568322329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 337723
- Practice address
- 390 South Ave Apt 405
Rochester, NY 14620-1060 - Phone
- (585) 629-7966
- NPI assigned
- Nov 14, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 337723 | NY | Primary |
Addresses
Primary practice location
390 South Ave Apt 405
Rochester, NY 14620-1060
Mailing address
390 South Ave Apt 405
Rochester, NY 14620-1060
Phone (585) 629-7966
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 |
|---|---|---|---|
| 337723 | NY | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1763078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763078400000",
"number": "1568322329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "390 SOUTH AVE APT 405",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146201060",
"telephone_number": "585-629-7966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "390 SOUTH AVE APT 405",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146201060",
"telephone_number": "585-629-7966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "MICHELE",
"middle_name": "N",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-11-14",
"last_updated": "2025-11-14",
"certification_date": "2025-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "337723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.