La Vaughnza Marie Jackson

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1448 5TH Ave
Bay Shore, NY 11706-4147

Phone

(631) 844-5913

NPI assigned

Sep 22, 2026

Last updated

Sep 22, 2026By the provider in NPPES

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

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

{
    "created_epoch": "1790035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1598677676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 5TH AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 5TH AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064147",
            "telephone_number": "631-844-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LA VAUGHNZA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-22",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Issing, PT,DPT
• J & J Home Care & Surgical Supply Inc.
• Jab Medical Supply LLC
• Bernice Jackson, NP
• Janea D Jackson
• Lisa Olivia Jackson, LMSW, CASAC
• Casey Jacobson, PA-C
• Veronique Marie-Andree Jacques, DNP MSN FNP-C
• Omkaar Jaikaran
• Alexa Jakacic, PA-C

• Student in an Organized Health Care Education/Training Program in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.