Taylor Jackson

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

707 E Merry Ave
Bowling Green, OH 43403-4502

Phone

(703) 835-4160

NPI assigned

Sep 6, 2015

Sex

Male

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)

Not enrolled

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

{
    "created_epoch": "1441497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441497600000",
    "number": "1992173025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10436 MALONE CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220322372",
            "telephone_number": "703-272-7394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E MERRY AVE",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434034502",
            "telephone_number": "703-835-4160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-06",
        "last_updated": "2015-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caleigh Instone
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• Irb Medical Equipment, LLC
• Jack a. Whittaker D.D.S., Inc.
• Timara Christina Jackson
• Cheryl Ann Jacobs, CPNP
• Elayne M Jacoby, C.N.P.
• Mohammed Jallad, FNP
• Zaqariah James, LSW

• Student in an Organized Health Care Education/Training Program in Bowling Green, OH
• Providers in Bowling Green, OH by specialty
• Student in an Organized Health Care Education/Training Program in Ohio

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

Verify at the official NPI Registry.