Roger Jackson

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

102279 Issued in TN

Practice address

171 Noah LN
La Follette, TN 37766-5575

Phone

(423) 912-5097

NPI assigned

May 24, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

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": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1720653629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 NOAH LN",
            "city": "LA FOLLETTE",
            "state": "TN",
            "postal_code": "377665575",
            "telephone_number": "423-912-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 NOAH LN",
            "city": "LA FOLLETTE",
            "state": "TN",
            "postal_code": "377665575",
            "telephone_number": "423-912-5097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ROGER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-24",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Case Management",
            "state": "TN",
            "license": "102279",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Community Health",
            "state": "TN",
            "license": "102279",
            "primary": false
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Hospice",
            "state": "TN",
            "license": "102279",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "TN",
            "license": "102279",
            "primary": false
        },
        {
            "code": "163WN1003X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Nutrition Support",
            "state": "TN",
            "license": "102279",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": "TN",
            "license": "102279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Internal and Pulmonary Medicine of Lafollette, PC
• Ray Howe Irwin Jr.
• Jamal Isber, M.D.
• Jeremiah Lee Jackson
• Kathy M Jackson, D.O.
• Emily C James, SPEECH PATHOLOGIST
• Chandler Jones, RRT
• Jamie M. Jones, BSN, RN
• Macy Reed Jones, OT
• Melissa Gay Justice, APRN BC

• Home Health Registered Nurse in La Follette, TN
• Providers in La Follette, TN by specialty
• Home Health Registered Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.