Active NPI
Jackie Lynn Agee, M.D.
- Pediatrics Physician
- Sacramento, CA
National Provider Identifier
1922021070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A47099
- Practice address
- 650 Howe Avenue,,Suite 100
Sacramento, CA 95825 - Phone
- (916) 924-9337
- Fax
- (916) 924-8281
- NPI assigned
- Jul 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G37462 | CA | |
| Pediatrics Physician | 208000000X | A47099 | CA | Primary |
Addresses
Primary practice location
650 Howe Avenue,,Suite 100
Sacramento, CA 95825
Mailing address
650 Howe Avenue., Suite 100
Sacramento, CA 95825
Phone (916) 924-9337
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A47099 | CA | MD | Pediatrics Physician |
| G37462 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386288000000",
"number": "1922021070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 HOWE AVENUE., SUITE 100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95825",
"telephone_number": "916-924-9337",
"fax_number": "916-924-8281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 HOWE AVENUE,,SUITE 100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95825",
"telephone_number": "916-924-9337",
"fax_number": "916-924-8281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGEE",
"first_name": "JACKIE",
"middle_name": "LYNN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2013-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G37462",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A47099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.