Active NPI
Sharie Jackson, MSN,RN
- Medical-Surgical Registered Nurse
- Mobile, AL
National Provider Identifier
1922762947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical-Surgical Registered Nurse
- License
- 1-107857
- Practice address
- 5659 Vanderbilt Dr
Mobile, AL 36608-3048 - Phone
- (251) 459-0518
- NPI assigned
- Oct 26, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | 1-107857 | AL | Primary |
Addresses
Primary practice location
5659 Vanderbilt Dr
Mobile, AL 36608-3048
Mailing address
5659 Vanderbilt Dr
Mobile, AL 36608-3048
Phone (251) 459-0518
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-107857 | Other | AL | ALABAMA BOARD OF NURSING |
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
- Master of Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-107857 | AL | MD | Medical-Surgical Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635206400000",
"number": "1922762947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5659 VANDERBILT DR",
"city": "MOBILE",
"state": "AL",
"postal_code": "366083048",
"telephone_number": "251-459-0518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5659 VANDERBILT DR",
"city": "MOBILE",
"state": "AL",
"postal_code": "366083048",
"telephone_number": "251-459-0518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "SHARIE",
"name_prefix": "Mrs.",
"credential": "MSN,RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-26",
"last_updated": "2021-10-26",
"certification_date": "2021-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "163WM0705X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Registered Nurse, Medical-Surgical",
"state": "AL",
"license": "1-107857",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALABAMA BOARD OF NURSING",
"identifier": "1-107857",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.