Teresa Jackson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

306 W Vliet St # 102
Milwaukee, WI 53212-4014

Phone

(414) 416-5749

NPI assigned

Mar 2, 2022

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.

• New Life Care Services LLC

  • Adult Care Home Facility
  • Milwaukee, WI
  • NPI 1508573486
  NPD Authorized official
• S&M Elite Transportation

  • Non-emergency Medical Transport (VAN)
  • Milwaukee, WI
  • NPI 1659159572
  NPD Authorized official

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1861149692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 W VLIET ST # 102",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532124014",
            "telephone_number": "414-416-5749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W VLIET ST # 102",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532124014",
            "telephone_number": "414-416-5749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TERESA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell Andrew Jackson, PHARMD
• Nastassia S Jackson, LPC-IT
• Nicole L. Jackson, CSAC, ICS, LPC-IT
• Stennen N Jackson
• Stephfon Jackson
• Thomas C Jackson, MD
• Tiffany Jackson
• Tracey Jackson
• Veronda Jackson
• Vickie Lee Jackson

• Case Manager/Care Coordinator in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Case Manager/Care Coordinator in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.