Jackie R Patton, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN 168364 Issued in OH

Practice address

29 Broad St
Glouster, OH 45732-1127

Phone

(740) 856-9788

Fax

(740) 767-2959

NPI assigned

Nov 12, 2012

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1352678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352678400000",
    "number": "1740524941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 BROAD ST",
            "city": "GLOUSTER",
            "state": "OH",
            "postal_code": "457321127",
            "telephone_number": "740-856-9788",
            "fax_number": "740-767-2959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 BROAD ST",
            "city": "GLOUSTER",
            "state": "OH",
            "postal_code": "457321127",
            "telephone_number": "740-856-9788",
            "fax_number": "740-767-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTON",
        "first_name": "JACKIE",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-12",
        "last_updated": "2012-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN 168364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Glouster, OH
• Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2012; 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.