Gajarah Jackson

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

800 Cooper St
Camden, NJ 08102-1155

Phone

(856) 342-3040

NPI assigned

Sep 10, 2024

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

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.

• CMC Department of Medicine Group PA

  • Specialist
  • Camden, NJ
  • NPI 1386682094
  NPD (past)
• CMC Psychiatric Associates, PC

  • Psychiatry Physician
  • Camden, NJ
  • NPI 1982646634
  NPD (past)

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1831925627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 COOPER ST STE 400",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081021100",
            "telephone_number": "856-342-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 COOPER ST",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081021155",
            "telephone_number": "856-342-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "GAJARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Effat Jabeen
• Karim Jaber, MD
• Lee M Jablow, MD
• Lilley Frances Jack
• Melina Jackman
• James Jackson, LCADC
• Sade Jackson
• Tasha Rose Jackson
• Aswathi Eliz Jacob, DO
• Saunjii J Jacobs, WHNP-BC

• Community Health Worker in Camden, NJ
• Providers in Camden, NJ by specialty
• Community Health Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.