Jacklin Anderson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

6960321 Issued in NY

Practice address

321 W Onondaga St
Suite 201
Syracuse, NY 13202-3207

Phone

(315) 478-0610

Fax

(315) 478-2510

NPI assigned

Oct 1, 2015

Last updated

Oct 1, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central New York Services

  • Addiction (Substance Use Disorder) Counselor
  • Syracuse, NY
  • NPI 1972041929
  NPD (past)

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

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443657600000",
    "number": "1720458904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 FERGERSON PARK",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132122323",
            "telephone_number": "315-727-4812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 W ONONDAGA ST",
            "address_2": "SUITE 201",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023207",
            "telephone_number": "315-478-0610",
            "fax_number": "315-478-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JACKLIN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-01",
        "last_updated": "2015-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "6960321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Edwin Andersen, OTR
• Brian P Anderson, MD
• Brittany Anderson
• Carol Anne Anderson, LMSW
• Denise Anderson, LMSW
• Jacob Eli Anderson, M.D.
• Jennifer Anne Anderson, FNP-C
• Karthika Mahendran Anderson, MD
• Kathleen Anderson, NP
• Kelvin Anderson, MD

• Registered Nurse in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; 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.