Active NPI
Sherrelle Princess Jackson, DNP
- Nurse Practitioner
- Houston, TX
National Provider Identifier
1871002857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 2017005851
- Practice address
- 6701 Fannin St
Houston, TX 77030-2608 - Phone
- (832) 822-4242
- NPI assigned
- Sep 22, 2017
- 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 | 2017005851 | TX | Primary |
Addresses
Primary practice location
6701 Fannin St
Houston, TX 77030-2608
Mailing address
2121 Allen Park Way
4088
Houston, TX 77019
Phone (843) 622-7043
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017005851 | TX | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lurie Children'S Medical Group, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Chicago, IL
- NPI 1992758544
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506038400000",
"number": "1871002857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2121 ALLEN PARK WAY",
"address_2": "4088",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77019",
"telephone_number": "843-622-7043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6701 FANNIN ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770302608",
"telephone_number": "832-822-4242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "SHERRELLE",
"middle_name": "PRINCESS",
"credential": "DNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-22",
"last_updated": "2017-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "2017005851",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.