Active NPI
Victoria Jackson, CNA
- Nursing Care Agency
- Kansas City, KS
National Provider Identifier
1992416580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Care Agency
- License
- 89290A
- Practice address
- 1126 Oakland Ave
Kansas City, KS 66102-2960 - Phone
- (816) 791-3174
- NPI assigned
- Dec 6, 2022
- 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 |
|---|---|---|---|---|
| Nursing Care Agency | 251J00000X | 89290A | MO | Primary |
Addresses
Primary practice location
1126 Oakland Ave
Kansas City, KS 66102-2960
Mailing address
1126 Oakland Ave
Kansas City, KS 66102-2960
Phone (816) 791-3174
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 |
|---|---|---|---|
| 89290A | MO | MD | Nursing Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670284800000",
"number": "1992416580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1126 OAKLAND AVE",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "661022960",
"telephone_number": "816-791-3174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1126 OAKLAND AVE",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "661022960",
"telephone_number": "816-791-3174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "VICTORIA",
"credential": "CNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-06",
"last_updated": "2022-12-06",
"certification_date": "2022-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": "MO",
"license": "89290A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.