Malinda M Jackson

Primary specialty

DriverTaxonomy code 172A00000X

Practice address

411 E William St
Decatur, IL 62523-1140

Phone

(217) 590-7433

Fax

(217) 615-7176

NPI assigned

Sep 27, 2021

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

Practice roles

Locations

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.

• Decatur City Taxi & Delivery Inc

  • Taxi
  • Decatur, IL
  • NPI 1295126837
  NPD

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1619648839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 E WILLIAM ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625231140",
            "telephone_number": "217-590-7433",
            "fax_number": "217-615-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E WILLIAM ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625231140",
            "telephone_number": "217-590-7433",
            "fax_number": "217-615-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MALINDA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J a K Enterprises Inc
• J a K Enterprises Inc
• Amia Jackson, RBT
• Debra Kay Jackson, M.D.
• Harmony Jackson
• Royalty Jackson
• Amanda Jacobsen, PA-C
• Jon Jacoby, MD
• Brian P Jacquot, P.A.-C
• Aftab Hassan Jafri, M.D.

• Driver in Decatur, IL
• Providers in Decatur, IL by specialty
• Driver in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.