Elizabeth Jackson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

221 Willow St
Yarmouth Port, MA 02675-1770

Phone

(508) 404-0827

NPI assigned

May 30, 2016

Last updated

Apr 6, 2024By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1464566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712361600000",
    "number": "1578911657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 WILLOW ST",
            "city": "YARMOUTH PORT",
            "state": "MA",
            "postal_code": "026751770",
            "telephone_number": "508-404-0827",
            "fax_number": "508-514-7936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 WILLOW ST",
            "city": "YARMOUTH PORT",
            "state": "MA",
            "postal_code": "026751770",
            "telephone_number": "508-404-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-30",
        "last_updated": "2024-04-06",
        "certification_date": "2024-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Katie E Ilkovich
• James T. Reimer, M.D., P.C.
• John Andrew Johnson Jr., D.O.
• Judith Recknagel MD
• Sheila Ann Kane, APRN,BC
• Edith Sanborn Kaselis, MD

• Case Manager/Care Coordinator in Yarmouth Port, MA
• Providers in Yarmouth Port, MA by specialty
• Case Manager/Care Coordinator in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2024; 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.