Shi Ronda Jackson, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP143014 Issued in TX

Practice address

4001 W Sam Houston Pkwy N Ste 110
Houston, TX 77043-1236

Phone

(713) 996-0900

NPI assigned

Jan 11, 2022

Last updated

Jan 11, 2022By the provider in NPPES

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

State licenses

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1629729678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18482 KUYKENDAHL RD # 541",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773798123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 W SAM HOUSTON PKWY N STE 110",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770431236",
            "telephone_number": "713-996-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHI RONDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP143014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawndrea Jackson
• Shelbria Jackson
• Sherrelle Princess Jackson, DNP
• Sheryl Swoopes Jackson
• Shetocquia Jackson
• Sierra Jackson, PT, DPT
• Simona Jackson, MD
• Stefanece Jackson
• Stequita C. Jackson, MD
• Syreena A. Jackson, PT, DPT,OCS

• Family Nurse Practitioner in Houston, TX
• Providers in Houston, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.