Jay Allen Jackson, RN

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

116352 Issued in IA

Practice address

601 Hospital Dr
Maquoketa, IA 52060-1201

Phone

(563) 652-2474

NPI assigned

Oct 2, 2023

Last updated

Oct 2, 2023By the provider in NPPES

Sex

Male

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1629858261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 N 9TH AVE",
            "city": "DONAHUE",
            "state": "IA",
            "postal_code": "527469800",
            "telephone_number": "239-888-3063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 HOSPITAL DR",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520601201",
            "telephone_number": "563-652-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JAY",
        "middle_name": "ALLEN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "IA",
            "license": "116352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackson County Public Hospital (Jackson County Regional Health Center)
• Jackson County Public Hospital (Jackson Co Regional Health Center Home & Community Health)
• Jackson County Public Hospital
• Jackson County Public Hospital (Jackson County Regional Health Center)
• Jackson Ia Opco LLC (Jackson Ridge Healthcare Center)
• Gloria Jorgensen
• Adrienne D'Agostino Kane, DDS
• Paul Henry Koob, DO
• Kari Kreel
• Marinna Lynne Kroh, MMFT

• General Practice Registered Nurse in Maquoketa, IA
• Providers in Maquoketa, IA by specialty
• General Practice Registered Nurse in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.