Jakson Nicholas Edward

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

202106698RN Issued in OR

Practice address

4585 SW 185TH Ave
Aloha, OR 97078-1557

Phone

(503) 591-9280

NPI assigned

Dec 31, 2012

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Trinity Care Services

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Cheyenne, WY
  • NPI 1588900310
  NPD (past)

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

{
    "created_epoch": "1356912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1861738486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 RAINBOW RD APT 106",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820016583",
            "telephone_number": "307-275-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4585 SW 185TH AVE",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970781557",
            "telephone_number": "503-591-9280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1603 Capitol Ave Ste 510",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820014563",
            "country_code": "US",
            "telephone_number": "307-635-2888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARD",
        "first_name": "JAKSON",
        "middle_name": "NICHOLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-31",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "WY",
            "license": "132080700",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "202106698RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kai-Ave James Douvia
• Doyel Maxus LLC
• Duncan Health Centers LLC
• Dynamic Core Care LLC
• Zachary Edmund
• Devon Ehrenberg, LMT
• Arlynn Ekis
• Erica Bronitsky, DMD, LLC
• Ernest R Thompson DMD PC
• TJ Ernst

• Registered Nurse in Aloha, OR
• Providers in Aloha, OR by specialty
• Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; 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.