Individual provider Active NPI

Clarence Jackson

  • Registered Nurse
  • Plantation, FL
National Provider Identifier
1700794336
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
9451191 Issued in FL
Practice address
4432 NW 8TH CT
Plantation, FL 33317-1511
Phone
(305) 924-2353
NPI assigned
Sep 1, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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 9451191 FL Primary

Addresses

Primary practice location

4432 NW 8TH CT
Plantation, FL 33317-1511

Mailing address

4432 NW 8TH CT
Plantation, FL 33317-1511
Phone (305) 924-2353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1700794336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4432 NW 8TH CT",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333171511",
            "telephone_number": "305-924-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4432 NW 8TH CT",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333171511",
            "telephone_number": "305-924-2353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CLARENCE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-01",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9451191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.