Folashade Agnes Jackson

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

309224 Issued in TX

Practice address

7330 San Pedro Ave Ste 800
San Antonio, TX 78216-6268

Phone

(210) 733-0524

NPI assigned

Feb 21, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Management & Business Associates, Inc.

  • Home Health Agency
  • San Antonio, TX
  • NPI 1962606368
  NPD (past)

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1962903468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16406 COLTS BAY",
            "city": "SELMA",
            "state": "TX",
            "postal_code": "781543895",
            "telephone_number": "240-291-3145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7330 SAN PEDRO AVE STE 800",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166268",
            "telephone_number": "210-733-0524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "FOLASHADE",
        "middle_name": "AGNES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-21",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "309224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Nicole Jackson
• Delores Jackson, LCSW
• E Penn Jackson Jr., DDS
• Eboney Jackson, PHD
• Ebony M Jackson, LVN
• Gregory M. Jackson II, FNP-C
• Gregory Mann Jackson, M.D.
• Hannah Joy Jackson, DO
• Hollie Jackson, RN
• James F. Jackson III, M.D.

• Licensed Vocational Nurse in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; 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.