Karena Z Jackson, LPPP

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

5047 S Galleria Dr
Salt Lake City, UT 84123-4695

Phone

(801) 486-8143

Fax

(801) 746-6090

NPI assigned

Jul 10, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Judicial Supervision Services, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Murray, UT
  • NPI 1487294252
  NPD Authorized official

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1821616368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5047 S GALLERIA DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841234695",
            "telephone_number": "801-486-8143",
            "fax_number": "801-746-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5047 S GALLERIA DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841234695",
            "telephone_number": "801-486-8143",
            "fax_number": "801-746-6090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1411 N State St Ste 4",
            "address_purpose": "LOCATION",
            "city": "Orem",
            "state": "UT",
            "postal_code": "840572584",
            "country_code": "US",
            "telephone_number": "801-746-6091 x1",
            "fax_number": "801-746-6090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "370 S 500 E",
            "address_2": "#130",
            "address_purpose": "LOCATION",
            "city": "Clearfield",
            "state": "UT",
            "postal_code": "84015",
            "country_code": "US",
            "telephone_number": "801-525-3009 x1",
            "fax_number": "801-746-6090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KARENA",
        "middle_name": "Z",
        "credential": "LPPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-10",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna J Jackson
• Jennifer Ann Jackson, LCSW
• Jillyn Jackson, PTA
• John Lawrence Jackson, PHD
• Julie Jackson, M.D.
• Kathleen Grace Jackson, DPT
• Kenneth Conrad Jackson II, PHARM.D., R.PH.
• Marie C Jackson, MSW, CSW
• Matthew Kory Jackson, D.C.
• Michael Jackson

• Case Manager/Care Coordinator in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Case Manager/Care Coordinator in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; 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.