Linda Elaine Jackson

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

321977 Issued in NY

Practice address

2901 216TH St
Bayside, NY 11360-2899

Phone

(718) 281-8800

NPI assigned

Aug 20, 2021

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

State licenses

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1588330344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6016 FRESH POND RD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113783454",
            "telephone_number": "347-423-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 216TH ST",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602899",
            "telephone_number": "718-281-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LINDA",
        "middle_name": "ELAINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "321977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Island Medical Care, PLLC
• Omnia Ismail
• Sarah Alexis Isrie
• Olga Ivanova, PPD, CLC
• Giyon Jackson
• Helene Marcia Jacobson, MSED
• Salome Jacques
• Jaeil Acupuncture PC
• Gholamreza Jahanara, DR PHYSICALTHERAPY
• Jae H Jahng, D.D.S.

• Licensed Practical Nurse in Bayside, NY
• Providers in Bayside, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; 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.