Active NPI
Deborah Ann Jackson, RD, LD/N
- Registered Dietitian
- Daphne, AL
National Provider Identifier
1750560686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND2804
- Practice address
- 27821 State Highway 181 Unit 903
Daphne, AL 36526-8662 - Phone
- (850) 512-5790
- NPI assigned
- Oct 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | ND2804 | FL | Primary |
Addresses
Primary practice location
27821 State Highway 181 Unit 903
Daphne, AL 36526-8662
Mailing address
27821 State Highway 181 Unit 903
Daphne, AL 36526-8662
Phone (850) 512-5790
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND2804 | FL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739059200000",
"number": "1750560686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27821 STATE HIGHWAY 181 UNIT 903",
"city": "DAPHNE",
"state": "AL",
"postal_code": "365268662",
"telephone_number": "850-512-5790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27821 STATE HIGHWAY 181 UNIT 903",
"city": "DAPHNE",
"state": "AL",
"postal_code": "365268662",
"telephone_number": "850-512-5790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "DEBORAH",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "RD, LD/N",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-10-27",
"last_updated": "2025-02-09",
"certification_date": "2025-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND2804",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Daphne, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.