NPI Code Detail JSON Logo

1457117285 NPI number — SHANDRIKA JACKSON RN

NPI Number: 1457117285
Health Care Provider/Practitioner: SHANDRIKA JACKSON RN

Information about “1457117285” NPI (SHANDRIKA JACKSON RN) exists in 1457117285 in HTML format HTML  |  1457117285 in plain Text format TXT  |  1457117285 in PDF (Portable Document Format) PDF  |  1457117285 in an XML format XML  formats.

NPI Number : 1457117285 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1457117285",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JACKSON",
    "FirstName": "SHANDRIKA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "RN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "7776 FARMINGTON BLVD UNIT 383394",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GERMANTOWN",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "38183-0488",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "901-265-4778",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "7844 MEADOW VALE DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MEMPHIS",
    "PracticeLocationAddressStateName": "TN",
    "PracticeLocationAddressPostalCode": "38125-3143",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "901-265-4778",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/28/2024",
    "LastUpdateDate": "02/28/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "372500000X",
          "TaxonomyName": "Chore Provider",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "372600000X",
          "TaxonomyName": "Adult Companion",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "3747A0650X",
          "TaxonomyName": "Attendant Care Provider",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "3747P1801X",
          "TaxonomyName": "Personal Care Attendant",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "374T00000X",
          "TaxonomyName": "Religious Nonmedical Nursing Personnel",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "374U00000X",
          "TaxonomyName": "Home Health Aide",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "376J00000X",
          "TaxonomyName": "Homemaker",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WH0200X",
          "TaxonomyName": "Home Health Registered Nurse",
          "LicenseNumber": "252054",
          "LicenseNumberStateCode": "TN",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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