Jackie D. Foreman, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP 19781 Issued in CA

Practice address

731 S Avenue 59
Los Angeles, CA 90042-5003

Phone

(620) 875-6462

NPI assigned

Jun 15, 2006

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)

Enrolled

Credentials

Nurse Practitioner

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.

• Front Porch Communities and Services

  • Skilled Nursing Facility
  • Santa Rosa, CA
  • NPI 1609549112
  NPD (past)
• Silver Continence Care Ca, Nursing PC

  • Nurse Practitioner
  • Glendale, CA
  • NPI 1578874350
  NPD (past)
• Digestive Health Center of the Four States, LLC

  • Gastroenterology Physician
  • Galena, KS
  • NPI 1053754986
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302048000000",
    "number": "1972547735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 S AVENUE 59",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900425003",
            "telephone_number": "620-875-6462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 S AVENUE 59",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900425003",
            "telephone_number": "620-875-6462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOREMAN",
        "first_name": "JACKIE",
        "middle_name": "D.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2011-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "139057",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP 19781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stewart Fordham, M.D.
• Gordon C Fordyce, OTR/L
• April Ellyn Fore
• Samuel Forel
• Allison Foreman
• Renee Foreman
• Resa None Foreman, LCSW
• Foremost Home Health Care Inc
• Tania Elizabeth Forero, LCSW
• Christine D Forest, MD

• Family Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; 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.