Deborah Dobey Jackson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

22799 Issued in SC

Practice address

4095 Country Club Rd
Spartanburg, SC 29302-4458

Phone

(864) 490-4810

NPI assigned

Aug 9, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Deborah Dobey Martin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1891249777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4095 COUNTRY CLUB RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293024458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4095 COUNTRY CLUB RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293024458",
            "telephone_number": "864-490-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DEBORAH",
        "middle_name": "DOBEY",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-09",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "SC",
            "license": "22799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "MARTIN",
            "middle_name": "DOBEY",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel P Jablonski, CRNA
• Tyler A Jack, D.C.
• Jackie Drummond Counseling LLC
• Melanie Lorraine Jacks, CCC-SLP
• Adrian Jackson Jr., DMD
• Jamie E Jackson, DC
• Jannah Alexa Jackson
• Kathy Lacole Jackson, RN, BSN
• Kimberly Jackson, CNA
• Kimberly R Jackson, LISW-CP

• Licensed Practical Nurse in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Licensed Practical Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; 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.