Charleen Jackson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F02180605 Issued in AL

Practice address

2423 Schillinger Rd S Ste 103
Mobile, AL 36695-4142

Phone

(251) 660-5950

Fax

(251) 660-5949

NPI assigned

Mar 7, 2018

Sex

Female

Sole proprietor

No

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 AL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  AL

  Medicare reassignment NPD
• University of South Alabama Health Care Authority

  • Internal Medicine Physician
  • Mobile, AL
  • NPI 1508392432
  NPD

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1821590647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 AIRPORT BLVD STE A101",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366086767",
            "telephone_number": "251-378-6209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 SCHILLINGER RD S STE 103",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366954142",
            "telephone_number": "251-660-5950",
            "fax_number": "251-660-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHARLEEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-07",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "F02180605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Robert Jackson, DO
• Ashley Jackson
• Ashley Marie Jackson, CRNP
• Brandi N Jackson
• Brianna Marie Jackson, PT, DPT
• Christina Jackson
• Cynthia M Jackson, CRNP
• Danielle Jackson
• Deasia Jackson
• Dianna O Jackson, R.N.

• Family Nurse Practitioner in Mobile, AL
• Providers in Mobile, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; 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.