Jeremiah Rashad Jackson

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Practice address

14253 W Aster Dr
Surprise, AZ 85379-5505

Phone

(205) 420-8155

NPI assigned

Jan 17, 2022

Sex

Male

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.

• Kappa Care LLC

  • Community/Behavioral Health Agency
  • Surprise, AZ
  • NPI 1215678552
  NPD Authorized official

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1588315980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14253 W ASTER DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853795505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14253 W ASTER DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853795505",
            "telephone_number": "205-420-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JEREMIAH",
        "middle_name": "RASHAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-17",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Clare Iwinski
• Michael Iyamu, D.O
• Izogn Group LLC
• Alina Hussein Jaafar, DMD
• Christopher Ladd Jackson, MC, LPC, LISAC, NCGC
• Kristin Jackson, EDS
• Melissa Jeree Jackson, LPC
• Ryne Jackson, DMD, MSD
• Hannah Jacobs, DOT
• Susan Andrea Jaffe, PT

• Community/Behavioral Health Agency in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.