Individual provider Active NPI

Janet Oni Jackson, RN

  • Registered Nurse
  • Indianapolis, IN
National Provider Identifier
1700309838
Registry record updated Jul 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
28190960A Issued in IN
Practice address
720 Eskenazi Ave
Indianapolis, IN 46202-5187
Phone
(317) 880-0000
NPI assigned
Jul 20, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28190960A IN Primary

Addresses

Primary practice location

720 Eskenazi Ave
Indianapolis, IN 46202-5187

Mailing address

5015 Karen Dr
Indianapolis, IN 46226-2564
Phone (317) 880-0000

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
28190960AINMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500508800000",
    "number": "1700309838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 KAREN DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462262564",
            "telephone_number": "317-880-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 ESKENAZI AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025187",
            "telephone_number": "317-880-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JANET",
        "middle_name": "ONI",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-20",
        "last_updated": "2017-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28190960A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2017; 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.