Velletta Ann Jackson, RN, MSN, CRRN

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

108011 Issued in GA

Practice address

611 Pine Ave
Albany, GA 31701-2403

Phone

(229) 288-3879

NPI assigned

Mar 6, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 15

Addresses

Other names 1

• Mrs. Velletta Ann Jackson-Love Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1932525581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2303 E ALBERSON DR",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317212045",
            "telephone_number": "229-288-3879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 PINE AVE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317012403",
            "telephone_number": "229-288-3879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "VELLETTA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RN, MSN, CRRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-06",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "GA",
            "license": "108011",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "108011",
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "108011",
            "primary": false
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "GA",
            "license": "108011",
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "GA",
            "license": "108011",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "GA",
            "license": "108011",
            "primary": true
        },
        {
            "code": "163WC1600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": "GA",
            "license": "108011",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "GA",
            "license": "108011",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "GA",
            "license": "108011",
            "primary": false
        },
        {
            "code": "163WN1003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nutrition Support",
            "state": "GA",
            "license": "108011",
            "primary": false
        },
        {
            "code": "163WP0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pain Management",
            "state": "GA",
            "license": "108011",
            "primary": false
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "GA",
            "license": "108011",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "GA",
            "license": "108011",
            "primary": false
        },
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "GA",
            "license": "108011",
            "primary": false
        },
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "GA",
            "license": "108011",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VELLETTA",
            "last_name": "JACKSON-LOVE",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "RN, MSN, CRRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Latonya Monique Jackson, LPN
• Leigh Anne Jackson, PHARMD
• Quenitra Q Jackson
• Ralph T Jackson Jr.
• Shameeka Kenyon Jackson
• Vicki Jackson
• Yolanda Deneen Jackson, CAREPROVIDER
• James M Freeman MD
• Charlee L James-Dailey
• Chirag R Jani, MD

• All providers in Albany, GA
• Community Health Registered Nurse in Georgia

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