Active NPI
Glendora D. Jackson
- Nurse's Aide
- Toledo, OH
National Provider Identifier
1982033635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- Practice address
- 428 N McCord Rd
Toledo, OH 43615-4835 - Phone
- (419) 450-9943
- NPI assigned
- Nov 4, 2013
- Last updated
- May 18, 2015
- 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 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chore Provider | 372500000X | OH | ||
| Adult Companion | 372600000X | OH | ||
| Attendant Care Provider | 3747A0650X | OH | ||
| Personal Care Attendant | 3747P1801X | OH | ||
| Home Health Aide | 374U00000X | OH | ||
| Homemaker | 376J00000X | OH | ||
| Nurse's Aide | 376K00000X | OH | Primary |
Addresses
Primary practice location
428 N McCord Rd
Toledo, OH 43615-4835
Mailing address
PO Box 352501
Toledo, OH 43635-2501
Phone (419) 450-9943
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431907200000",
"number": "1982033635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 352501",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436352501",
"telephone_number": "419-450-9943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "428 N MCCORD RD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436154835",
"telephone_number": "419-450-9943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "GLENDORA",
"middle_name": "D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-04",
"last_updated": "2015-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "372500000X",
"taxonomy_group": "",
"desc": "Chore Provider",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "OH",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.