Active NPI
Shirell Robinson Jackson
- Driver
- Hammond, LA
National Provider Identifier
1972203867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 007029882
- Practice address
- 20181 Skinner Dr
Hammond, LA 70401-4022 - Phone
- (985) 215-1538
- NPI assigned
- Mar 8, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | |||
| Driver | 172A00000X | 007029882 | LA | Primary |
Addresses
Primary practice location
20181 Skinner Dr
Hammond, LA 70401-4022
Mailing address
20181 Skinner Dr
Hammond, LA 70401-4022
Phone (985) 215-1538
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007029882 | LA | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678233600000",
"number": "1972203867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20181 SKINNER DR",
"city": "HAMMOND",
"state": "LA",
"postal_code": "704014022",
"telephone_number": "985-215-1538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20181 SKINNER DR",
"city": "HAMMOND",
"state": "LA",
"postal_code": "704014022",
"telephone_number": "985-215-1538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "SHIRELL",
"middle_name": "ROBINSON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-08",
"last_updated": "2023-03-08",
"certification_date": "2023-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": null,
"license": null,
"primary": false
},
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "LA",
"license": "007029882",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hammond, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.