Katelyn Jackson

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

371288 Issued in OH

Practice address

424 Savannah Rd
Lewes, DE 19958-1462

Phone

(419) 356-4784

NPI assigned

Oct 27, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

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": "1477526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1699227413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5370 ADELLA ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436132779",
            "telephone_number": "419-356-4784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 SAVANNAH RD",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199581462",
            "telephone_number": "419-356-4784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KATELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-27",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "371288",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9424562",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "2308512",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert A Irwin, M.S., CCC-SLP
• Eugene E Isaac, P.A.-C
• Malick G Islam, MD, FACC
• Anastasiia S Israel, NP
• Stephen M Israel, NP
• Shawntay Jackson
• Matthew Jacob, MD
• James Spellman MD LLC
• Lee Ann Janaskie, OTR/L
• Bradley Janson

• Registered Nurse in Lewes, DE
• Providers in Lewes, DE by specialty
• Registered Nurse in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; 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.