Sarelyn Bertina Jackson

Primary specialty

Sonography Radiologic TechnologistTaxonomy code 2471S1302X

License

51781 Issued in FL

Practice address

65 3Rd St NW
Suite 200
Winter Haven, FL 33881-4670

Phone

(863) 299-2424

Fax

(863) 299-4848

NPI assigned

Nov 5, 2010

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

Other names 1

• Mrs. Claudia Lopez Batz Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jackson Diagnostic Imaging, Inc

  • Mobile Radiology Clinic/Center
  • Winter Haven, FL
  • NPI 1750513016
  NPD (past) Authorized official

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

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288915200000",
    "number": "1790086841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 3RD ST NW",
            "address_2": "SUITE 200",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814670",
            "telephone_number": "863-299-2424",
            "fax_number": "863-299-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 3RD ST NW",
            "address_2": "SUITE 200",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814670",
            "telephone_number": "863-299-2424",
            "fax_number": "863-299-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SARELYN",
        "middle_name": "BERTINA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-05",
        "last_updated": "2010-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "FL",
            "license": "51781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLAUDIA",
            "last_name": "BATZ",
            "middle_name": "LOPEZ",
            "prefix": "MRS.",
            "credential": "ARDMS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• J&Y Assisted Living for the Ages
• Jackson Diagnostic Imaging, Inc
• Daniel Jackson, COTA
• Jillian J Jackson, LCSW
• Patrice Jackson
• Stephanie Kay Jackson
• Jared Jacobs, APRN
• Maria Jaimes-Cid
• James a Truitt DMD PA
• James J Booker IV MD PA

• Sonography Radiologic Technologist in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Sonography Radiologic Technologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; 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.