Individual provider Active NPI

Quiana Jackson

  • Licensed Practical Nurse
  • Rochester, NY
National Provider Identifier
1801243928
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
321273 Issued in NY
Practice address
15 Berry St
Rochester, NY 14609-7119
Phone
(585) 305-1784
NPI assigned
May 18, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 321273 NY Primary

Addresses

Primary practice location

15 Berry St
Rochester, NY 14609-7119

Mailing address

15 Berry St
Rochester, NY 14609-7119
Phone (585) 305-1784

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

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1801243928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BERRY ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146097119",
            "telephone_number": "585-305-1784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 BERRY ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146097119",
            "telephone_number": "585-305-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "QUIANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "321273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.