Anquanette Jackson

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

2400 S Ridgewood Ave
South Daytona, FL 32119-3097

Phone

(305) 928-0167

NPI assigned

Nov 20, 2017

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

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1679087282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 LAGORCE TER",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327388973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S RIDGEWOOD AVE",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321193097",
            "telephone_number": "305-928-0167"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "579 Lagorce Ter",
            "address_purpose": "LOCATION",
            "city": "Deltona",
            "state": "FL",
            "postal_code": "327388973",
            "country_code": "US",
            "telephone_number": "305-928-0167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANQUANETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Youchang Hu, AP
• Loren Huffines
• Jazmine Hunt, MS
• Injury Health Center
• Yusuf M Ismail, RPH
• Corey E Jackson
• Rosita Jahankhani
• Jason R Mercer MD PA
• Jordan Jenkins
• John W. Sloane, DMD

• Counselor in South Daytona, FL
• Providers in South Daytona, FL by specialty
• Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.