Individual provider Active NPI

Karen Johnston Jackson

  • Oncology Registered Nurse
  • Traverse City, MI
National Provider Identifier
1992664569
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oncology Registered NurseTaxonomy code 163WX0200X
License
4704210922 Issued in MI
Practice address
217 S Madison St
Traverse City, MI 49684-2321
Phone
(231) 392-8400
Fax
(231) 392-8400
NPI assigned
Jan 20, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Registered Nurse 163WX0200X 4704210922 MI Primary

Addresses

Primary practice location

217 S Madison St
Traverse City, MI 49684-2321

Mailing address

217 S Madison St
Traverse City, MI 49684-2321
Phone (231) 392-8400

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

LicenseStateTypeSpecialty
4704210922MIMDOncology Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1768867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1992664569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 S MADISON ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842321",
            "telephone_number": "231-392-8400",
            "fax_number": "231-392-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 S MADISON ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842321",
            "telephone_number": "231-392-8400",
            "fax_number": "231-392-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON JACKSON",
        "first_name": "KAREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-20",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "MI",
            "license": "4704210922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; 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.