Melody Felissa Jackson

Primary specialty

Pediatric Registered NurseTaxonomy code 163WP0200X

License

211763 Issued in FL

Practice address

1611 NW 12TH Ave
Miami, FL 33136-1005

Phone

(305) 585-5143

NPI assigned

Nov 25, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Melody Felissa Miller 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": "1416873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1902203557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21150 NE MIAMI CT",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331791033",
            "telephone_number": "305-585-5143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MELODY",
        "middle_name": "FELISSA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-25",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "FL",
            "license": "211763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELODY",
            "last_name": "MILLER",
            "middle_name": "FELISSA",
            "prefix": "MS.",
            "credential": "ARNP/MSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lance Jackson, LMHC
• Latoya Jackson
• Lewis Jackson Jr., M.D.
• Marie-Therese Jackson, PHARM.D.
• Melissa Jackson, M.D.
• Meredeth McHugh Jackson, APRN
• Richard P Jackson
• Robert Mark Jackson, MD
• Rosemary Jackson, MD, MPH
• Salonika Jackson

• Pediatric Registered Nurse in Miami, FL
• Providers in Miami, FL by specialty
• Pediatric Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; 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.