Active NPI
Germaine Ronkeith Jackson
- Licensed Practical Nurse
- New Orleans, LA
National Provider Identifier
1861984890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 20121157
- Practice address
- 5555 Bullard Ave
New Orleans, LA 70128-3450 - Phone
- (504) 240-2696
- NPI assigned
- Jun 5, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 20121157 | LA | Primary |
Addresses
Primary practice location
5555 Bullard Ave
New Orleans, LA 70128-3450
Mailing address
637 Oakwood Dr
Gretna, LA 70056-2932
Phone (504) 729-0299
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20121157 | LA | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528156800000",
"number": "1861984890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "637 OAKWOOD DR",
"city": "GRETNA",
"state": "LA",
"postal_code": "700562932",
"telephone_number": "504-729-0299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5555 BULLARD AVE",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701283450",
"telephone_number": "504-240-2696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "GERMAINE",
"middle_name": "RONKEITH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-05",
"last_updated": "2018-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "LA",
"license": "20121157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Orleans, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.