Latoiya Talisha Jackson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

156713 Issued in OH

Practice address

38280 Tamarac Blvd Apt# 102
Willoughby, OH 44094

Phone

(216) 849-2438

NPI assigned

Oct 28, 2015

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": "1445990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445990400000",
    "number": "1659743789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38280 TAMARAC BLVD APT 102",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440948162",
            "telephone_number": "216-849-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38280 TAMARAC BLVD APT# 102",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "44094",
            "telephone_number": "216-849-2438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LATOIYA",
        "middle_name": "TALISHA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-28",
        "last_updated": "2015-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "156713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdul Latif Itani, MD
• Izold a Malament MD Inc
• J. Michael Vento, M.D.
• Jack Anstandig, M.D., Inc.
• Kim Yvette Jackson, LPN
• Traci Jackson
• Bruce Robert Jacobson, M.D.
• David Jacobson Jr., PA
• Neil A Jacobson, MD
• Jamal Azem, M.D., Inc

• Licensed Practical Nurse in Willoughby, OH
• Providers in Willoughby, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; 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.