Active NPI
Ciara Sheree Jackson
- Nurse's Aide
- Fayetteville, NC
National Provider Identifier
1780566406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 577988
- Practice address
- 616 Cassell Dr Apt 104
Fayetteville, NC 28311-1666 - Phone
- (910) 689-6953
- NPI assigned
- Jul 23, 2025
- Last updated
- Aug 4, 2025
- Sex
- Unspecified or another gender identity
- 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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 577988 | NC | Primary |
Addresses
Primary practice location
616 Cassell Dr Apt 104
Fayetteville, NC 28311-1666
Mailing address
616 Cassell Dr Apt 104
Fayetteville, NC 28311-1666
Phone (910) 689-6953
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 |
|---|---|---|---|
| 577988 | NC | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754265600000",
"number": "1780566406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "616 CASSELL DR APT 104",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283111666",
"telephone_number": "910-689-6953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "616 CASSELL DR APT 104",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283111666",
"telephone_number": "910-689-6953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CIARA",
"middle_name": "SHEREE",
"sole_proprietor": "YES",
"sex": "X",
"enumeration_date": "2025-07-23",
"last_updated": "2025-08-04",
"certification_date": "2025-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "NC",
"license": "577988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.