Individual provider Active NPI

Christine Jackson, RN

  • Registered Nurse
  • Augusta, GA
National Provider Identifier
1710130968
Registry record updated Nov 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN157911 Issued in GA
Practice address
2260 Wrightsboro Rd
Augusta, GA 30904-4764
Phone
(706) 481-7619
NPI assigned
Nov 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2008

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 RN157911 GA Primary

Addresses

Primary practice location

2260 Wrightsboro Rd
Augusta, GA 30904-4764

Mailing address

8 Knollwood Blvd
North Augusta, SC 29841-2123
Phone (803) 441-8331

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
RN157911GAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1225497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225497600000",
    "number": "1710130968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 KNOLLWOOD BLVD",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298412123",
            "telephone_number": "803-441-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 WRIGHTSBORO RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044764",
            "telephone_number": "706-481-7619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHRISTINE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-01",
        "last_updated": "2008-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN157911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2008; 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.