London Teri Jackson, FNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

8735023-4405 Issued in UT

Practice address

405 S Main St
Springville, UT 84663-2252

Phone

(801) 491-2238

NPI assigned

Aug 6, 2020

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

• Miss London Teri Robert Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ljackson23183@foothillfamilyclinic.gardenplot.direct-ci.com
• Direct secure messaging: london.jackson.1@30906.direct.athenahealth.com

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.

• Aura Migraine Clinic PLLC

  • Family Nurse Practitioner
  • Orem, UT
  • NPI 1073382701
  NPD (past) Authorized official

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1902416795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 S MAIN ST",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846632252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S MAIN ST",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846632252",
            "telephone_number": "801-491-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LONDON",
        "middle_name": "TERI",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "UT",
            "license": "8735023-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LONDON",
            "last_name": "ROBERT",
            "middle_name": "TERI",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ihc Health Services Inc
• J & E Young
• Aaron Paul Jackson, PH.D.
• Edward William Jackson, MD
• Jonathan D Jackson, D.D.S.
• Michael Robert Jackson, CSW
• Christopher Jacob, O.D.
• Allessandra Corine Jacobsen, LAMFT
• Kevin Jacobsen
• Pamela Jamison, M.E/CCC-SLP

• Primary Care Nurse Practitioner in Springville, UT
• Providers in Springville, UT by specialty
• Primary Care Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; 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.