Active NPI
Ylencia D Jackson, NP
- Nurse Practitioner
- Warner Robins, GA
National Provider Identifier
1851748602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 147416
- Practice address
- 100 Jim Mason CT
Ste a
Warner Robins, GA 31088-8965 - Phone
- (478) 474-2947
- Fax
- (478) 971-4004
- NPI assigned
- May 23, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 147416 | GA | Primary |
Addresses
Primary practice location
100 Jim Mason CT
Ste a
Warner Robins, GA 31088-8965
Mailing address
306 Meadowridge Dr
Ste a
Warner Robins, GA 31093-2128
Phone (478) 929-8847
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 147416 | GA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470096000000",
"number": "1851748602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 MEADOWRIDGE DR",
"address_2": "STE A",
"city": "WARNER ROBINS",
"state": "GA",
"postal_code": "310932128",
"telephone_number": "478-929-8847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 JIM MASON CT",
"address_2": "STE A",
"city": "WARNER ROBINS",
"state": "GA",
"postal_code": "310888965",
"telephone_number": "478-474-2947",
"fax_number": "478-971-4004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "YLENCIA",
"middle_name": "D",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-23",
"last_updated": "2016-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "147416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warner Robins, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.