Shelia Shenell Jackson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

TAP002970 Issued in LA

Practice address

7505 Pines Rd
Ste 1250
Shreveport, LA 71129-3935

Phone

(318) 686-3770

Fax

(318) 686-3838

NPI assigned

Oct 11, 2012

Sex

Female

Sole proprietor

Yes

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

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1982956108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7505 PINES RD",
            "address_2": "STE 1250",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711293935",
            "telephone_number": "318-686-3770",
            "fax_number": "318-686-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7505 PINES RD",
            "address_2": "STE 1250",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711293935",
            "telephone_number": "318-686-3770",
            "fax_number": "318-686-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHELIA",
        "middle_name": "SHENELL",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-11",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "TAP002970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Jackson Jr.
• Ricky Adonis Jackson, PHARM.D.
• Robert Hutchinson Jackson, M.D.
• Sandra Jackson
• Sandra Gail Jackson
• Sherry A Jackson, BS, NCTMB, LMT, MLDC
• Shondia Jackson
• Tammi Jackson
• Terry Lynn Jackson, DNP, ACNPC-AG
• Tierrani Jackson

• Family Nurse Practitioner in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.