Latasha Marie Jackson

Primary specialty

Adult CompanionTaxonomy code 372600000X

Practice address

2259 Old Villa Rica Rd
Powder Springs, GA 30127-1506

Phone

(216) 507-8284

NPI assigned

Oct 2, 2023

Last updated

Oct 2, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1720868409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2259 OLD VILLA RICA RD",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301271506",
            "telephone_number": "216-507-8284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2259 OLD VILLA RICA RD",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301271506",
            "telephone_number": "216-507-8284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LATASHA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J.Dewar Surgical Services LLC
• Brionka Jackson, RBT
• Dominique Jackson
• Felton Lewis Jackson III
• Kevin R Jackson, DDS
• Robert John Jacobs, LPC
• Cynthia Ann Jaworski, A.T.,C
• Evens Jean-Louis
• Demetria Jennings, LMSW
• Meline Jeudy

• Adult Companion in Powder Springs, GA
• Providers in Powder Springs, GA by specialty
• Adult Companion in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.