Active NPI
Lavett Jackson
- Registered Nurse
- Clearwater, FL
National Provider Identifier
1972903912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN9372455
- Practice address
- 2188 58TH St N
Clearwater, FL 33760-3112 - Phone
- (727) 327-7656
- Fax
- (727) 322-2142
- NPI assigned
- Aug 27, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN9372455 | FL | Primary |
Addresses
Primary practice location
2188 58TH St N
Clearwater, FL 33760-3112
Mailing address
2188 58TH St N
Clearwater, FL 33760-3112
Phone (727) 327-7656
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 |
|---|---|---|---|
| RN9372455 | FL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409097600000",
"number": "1972903912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2188 58TH ST N",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337603112",
"telephone_number": "727-327-7656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2188 58TH ST N",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337603112",
"telephone_number": "727-327-7656",
"fax_number": "727-322-2142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "LAVETT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-27",
"last_updated": "2014-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "FL",
"license": "RN9372455",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.