Rosemary B Jackson, MSW,LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

001760 Issued in MO

Practice address

2650 Olive St
Saint Louis, MO 63103-1424

Phone

(314) 371-6500

Fax

(314) 371-6508

NPI assigned

May 17, 2007

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

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Emergence Psychological Services

  • Community/Behavioral Health Agency
  • Saint Louis, MO
  • NPI 1194140756
  Medicare reassignment NPD

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1790992576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 OLIVE ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631031424",
            "telephone_number": "314-371-6500",
            "fax_number": "314-371-6508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 OLIVE ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631031424",
            "telephone_number": "314-371-6500",
            "fax_number": "314-371-6508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ROSEMARY",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "MSW,LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "001760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip Eugene Jackson, LMSW
• Phyllis Jackson, LISW
• Rebecca Jackson, SLP
• Ron Darryl Jackson, DDS
• Rose Louise Jackson
• Royce Jackson, MS CF-SLP
• Ryan Scott Jackson, MD
• Shawn Jackson
• Sherri Lynne Jackson, MD
• Sherrill M Jackson, CPNP

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.