Active NPI
Cortnie Jackson
- Nurse's Aide
- Massillon, OH
National Provider Identifier
1619706827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 501027661005
- Practice address
- 8818 Ontario St NW
Massillon, OH 44646-1656 - Phone
- (133) 020-5772
- NPI assigned
- Jul 29, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 501027661005 | OH | Primary |
Addresses
Primary practice location
8818 Ontario St NW
Massillon, OH 44646-1656
Mailing address
8818 Ontario St NW
Massillon, OH 44646-1656
Phone (133) 020-5772
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 501027661005 | OH | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722211200000",
"number": "1619706827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8818 ONTARIO ST NW",
"city": "MASSILLON",
"state": "OH",
"postal_code": "446461656",
"telephone_number": "133-020-5772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8818 ONTARIO ST NW",
"city": "MASSILLON",
"state": "OH",
"postal_code": "446461656",
"telephone_number": "133-020-5772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CORTNIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-29",
"last_updated": "2024-07-29",
"certification_date": "2024-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "OH",
"license": "501027661005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Massillon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.