Active NPI
Shelon Jackson
- Counselor
- Las Vegas, NV
National Provider Identifier
1992107916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 2815 W Ford Ave
#1175
Las Vegas, NV 89123-6664 - Phone
- (702) 418-6472
- NPI assigned
- Sep 22, 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chore Provider | 372500000X | |||
| Adult Companion | 372600000X | |||
| Attendant Care Provider | 3747A0650X | |||
| Counselor | 101Y00000X | Primary | ||
| Homemaker | 376J00000X |
Addresses
Primary practice location
2815 W Ford Ave
#1175
Las Vegas, NV 89123-6664
Mailing address
2815 W Ford Ave
#1175
Las Vegas, NV 89123-6664
Phone (702) 418-6472
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": "1411344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614124800000",
"number": "1992107916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2815 W FORD AVE",
"address_2": "#1175",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891236664",
"telephone_number": "702-418-6472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2815 W FORD AVE",
"address_2": "#1175",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891236664",
"telephone_number": "702-418-6472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "SHELON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-22",
"last_updated": "2021-02-24",
"certification_date": "2021-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "372500000X",
"taxonomy_group": "",
"desc": "Chore Provider",
"state": null,
"license": null,
"primary": false
},
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": false
},
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
},
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.