ROGER JACKSON NPI 1720653629

NPI Information

NPI: 1720653629
Provider Name: ROGER JACKSON
Classification: Registered Nurse - 163WH0200X
Entity Type: Individual

Specialization: Home Health

Address:
171 NOAH LN
LA FOLLETTE, TN
ZIP 37766
Phone: (423) 912-5097
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Roger Jackson is a home health registered nurse in La Follette, TN. Roger Jackson NPI is 1720653629. The provider is registered as an individual entity type and is a multiple single specialty group.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

171 NOAH LN
LA FOLLETTE, TN
ZIP 37766-575
Phone: (423) 912-5097

The enumeration date for this NPI number is 5/24/2021 and was last updated on 5/24/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WC0400X	Registered Nurse	Case Management	102279	TENNESSEE	No
2	163WC1500X	Registered Nurse	Community Health	102279	TENNESSEE	No
3	163WH1000X	Registered Nurse	Hospice	102279	TENNESSEE	No
4	163WM0705X	Registered Nurse	Medical-Surgical	102279	TENNESSEE	No
5	163WN1003X	Registered Nurse	Nutrition Support	102279	TENNESSEE	No
6	163WH0200X	Registered Nurse	Home Health	102279	TENNESSEE	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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