Active NPI
Tashae L Jackson
- Licensed Practical Nurse
- Akron, OH
National Provider Identifier
1881021384
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Jun 20, 2022.
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN-141-207
- Practice address
- 1900 Newton St Apt H
Akron, OH 44305-3069 - Phone
- (330) 962-5918
- NPI assigned
- Sep 30, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | PN-141-207 | OH | Primary |
Addresses
Primary practice location
1900 Newton St Apt H
Akron, OH 44305-3069
Mailing address
1900 Newton St Apt H
Akron, OH 44305-3069
Phone (330) 962-5918
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TLJ5918 | Medicaid | OH |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN-141-207 | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380499200000",
"number": "1881021384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 NEWTON ST APT H",
"city": "AKRON",
"state": "OH",
"postal_code": "443053069",
"telephone_number": "330-962-5918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 NEWTON ST APT H",
"city": "AKRON",
"state": "OH",
"postal_code": "443053069",
"telephone_number": "330-962-5918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "TASHAE",
"middle_name": "L",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-30",
"last_updated": "2013-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "PN-141-207",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "TLJ5918",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Akron, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.