Active NPI
Emma Jackson
- Registered Nurse
- Sumter, SC
National Provider Identifier
1629699871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R155044
- Practice address
- 105 N Magnolia St
Sumter, SC 29150-4941 - Phone
- (803) 773-5511
- NPI assigned
- Apr 29, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R155044 | MD | Primary |
Addresses
Primary practice location
105 N Magnolia St
Sumter, SC 29150-4941
Mailing address
5615 Family LN
Rembert, SC 29128-9166
Phone (240) 441-2797
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 |
|---|---|---|---|
| R155044 | MD | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588118400000",
"number": "1629699871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5615 FAMILY LN",
"city": "REMBERT",
"state": "SC",
"postal_code": "291289166",
"telephone_number": "240-441-2797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 N MAGNOLIA ST",
"city": "SUMTER",
"state": "SC",
"postal_code": "291504941",
"telephone_number": "803-773-5511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "EMMA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-29",
"last_updated": "2020-04-29",
"certification_date": "2020-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MD",
"license": "R155044",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sumter, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.