Active NPI
Danny Jackson, BSN
- Pediatric Registered Nurse
- Gallup, NM
National Provider Identifier
1932525938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Registered Nurse
- License
- 641564
- Practice address
- 516 E. Nizhoni Blvd
Gallup, NM 87301-1337 - Phone
- (505) 722-1000
- NPI assigned
- Mar 14, 2014
- Last updated
- Mar 14, 2014
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Registered Nurse | 163WP0200X | 641564 | TX | Primary |
Addresses
Primary practice location
516 E. Nizhoni Blvd
Gallup, NM 87301-1337
Mailing address
PO Box 1337
516 E. Nizhoni Blvd
Gallup, NM 87301-1337
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
- Bachelor on Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 641564 | TX | MD | Pediatric Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394755200000",
"number": "1932525938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1337",
"address_2": "516 E. NIZHONI BLVD",
"city": "GALLUP",
"state": "NM",
"postal_code": "873011337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 E. NIZHONI BLVD",
"city": "GALLUP",
"state": "NM",
"postal_code": "873011337",
"telephone_number": "505-722-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "DANNY",
"name_prefix": "Mr.",
"credential": "BSN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-14",
"last_updated": "2014-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Pediatrics",
"state": "TX",
"license": "641564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gallup, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.