Active NPI
La Scienya Marie Jackson, M.D.
- Family Medicine Physician
- Miramar, FL
National Provider Identifier
1679763841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A111227
- Practice address
- 3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308 - Phone
- (877) 866-7123
- NPI assigned
- Jul 25, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | A111227 | CA | Primary |
Addresses
Primary practice location
3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308
Mailing address
80 Seymour St
Hartford, CT 06102-8000
Phone (860) 545-5201
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A111227 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vohra Wound Physicians of Ca, P.C. | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Dinuba, CA
- NPI 1841599339
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339718400000",
"number": "1679763841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 SEYMOUR ST",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061028000",
"telephone_number": "860-545-5201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 SW 160TH AVE",
"address_2": "SUITE 250",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330276308",
"telephone_number": "877-866-7123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "LA SCIENYA",
"middle_name": "MARIE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-25",
"last_updated": "2012-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A111227",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miramar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.