Andrea Monet Jackson

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

118 S 7TH St FL 2
Newark, NJ 07107-3750

Phone

(973) 855-1610

NPI assigned

Feb 6, 2023

Last updated

Feb 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1962108571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 S 7TH ST FL 2",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073750",
            "telephone_number": "973-855-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 S 7TH ST FL 2",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073750",
            "telephone_number": "973-855-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANDREA",
        "middle_name": "MONET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Izsak, MD
• J. Slim, LLC
• J&J St Michaels Pharmacy Inc.
• Joanna Jacinto
• Alexandra Jackovich, MD
• Brittany Nicole Jackson
• Cordero Jackson, BSN RN
• Douglas T Jackson, MD
• Eric Robert Jackson Jr., PA-C
• John H Jackson Jr.

• Student in an Organized Health Care Education/Training Program in Newark, NJ
• Providers in Newark, NJ by specialty
• Student in an Organized Health Care Education/Training Program in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.