Brenda Lynn Jackson, B.S. BUSINESS

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

2088 Stedman LN
Dayton, OH 45431-3000

Phone

(937) 797-7627

NPI assigned

Nov 4, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1780391078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2088 STEDMAN LN",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454313000",
            "telephone_number": "937-797-7627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2088 STEDMAN LN",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454313000",
            "telephone_number": "937-797-7627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2707 Old Yellow Springs Rd Apt 105",
            "address_purpose": "LOCATION",
            "city": "Fairborn",
            "state": "OH",
            "postal_code": "453242684",
            "country_code": "US",
            "telephone_number": "937-797-7618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRENDA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "B.S. BUSINESS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "OH",
            "license": "UX856711",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Jackson, RDN, LD
• Amanda Jackson
• Atiba Diarra Jackson, M.D.
• Bertha E Jackson
• Billy Jerome Jackson
• Carl'Averis Jackson
• Carroll S Jackson, L.I.S.W.
• Chinah Lynn Jackson
• Courtney Faith Jackson
• Courtney L Jackson, SWA

• Personal Care Attendant in Dayton, OH
• Providers in Dayton, OH by specialty
• Personal Care Attendant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; 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.