Angella Jackson, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

817058 Issued in NJ

Practice address

85 Summit St
Monroe, NY 10950-2503

Phone

(914) 563-4785

NPI assigned

Apr 4, 2018

Sex

Female

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

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• SBH Physicians, PC

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1740595917

  Dietitian, Registered

  Medicare reassignment NPD
• SBH Physicians, PC

  • Pediatrics Physician
  • Bronx, NY
  • NPI 1457665937
  NPD
• Quarry Road Emergency Services P.C.

  • Emergency Medicine Physician
  • Bronx, NY
  • NPI 1134238199
  NPD (past)

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1881190122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1154",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "102761154",
            "telephone_number": "914-563-4785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 SUMMIT ST",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109502503",
            "telephone_number": "914-563-4785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANGELLA",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": "817058",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NJ",
            "license": "817058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raizy Indig
• Isaac Reich MD PLLC
• Mona Itkonitz, RDH
• Leonid Izikson, M.D.
• Ali Jaber
• Chaya G Jacobowitz
• Cheskel Jacobowitz
• Auleen James
• Davika James, RN
• Bleron Jance

• Registered Dietitian in Monroe, NY
• Providers in Monroe, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.