JEROME SANTOS JACKSON (NPI# 1639678196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639678196 |
| Entity Type | Individual |
| Full Name | JEROME SANTOS JACKSON |
| Practice Address |
1951 Stella Lake St Ste 36 Las Vegas NV 89106-2144 |
| Mailing Address |
2051 N Torrey Pines Dr Apt 2042 Las Vegas NV 89108-6526 |
| Practice Telephone | 7025958309 |
| Enumeration Date | 2018-02-09 |
| Last Update Date | 2018-02-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | B9824255 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245841303 | Jerome Christopher Jackson | Non-emergency Medical Transport (VAN) | 314 Canaan Cir, Suffolk, VA 23435-3536 | 2020-08-12 |
| 1740815497 | Jerome Alexander-terrell Jackson | Respite Care | 9680 W Northern Ave Unit 2311, Peoria, AZ 85345-4655 | 2020-03-03 |
| 1235414202 | Jerome Sean Jackson | Pharmacist | 1198 W. Kemper Road, Walgreens, Cincinnati, OH 45224 | 2011-10-20 |
| 1518292796 | Jerome Ester Jackson | Counselor | 3838 N West Ave, Fresno, CA 93705-2703 | 2009-10-06 |
| 1659855914 | Jerome Adrian Jackson Jr. | Dentist | 2100 Miller Park Way, West Milwaukee, WI 53219-1641 | 2018-09-21 |
| Street Address |
1951 STELLA LAKE ST STE 36 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89106-2144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174894083 | Abiding Home Care Services | Home Health | 1951 Stella Lake St Ste 36, Las Vegas, NV 89106-2144 | 2012-01-24 |
| 1295376143 | Jullian Desuzzahn Bowsky | Technician | 1951 Stella Lake St Ste 36, Las Vegas, NV 89106-2144 | 2019-10-02 |
| 1245885847 | Perla Esmeralda Sosa | Technician | 1951 Stella Lake St Ste 36, Las Vegas, NV 89106-2144 | 2019-08-09 |
| 1184279473 | Sofia Valdez Ramirez | Technician | 1951 Stella Lake St Ste 36, Las Vegas, NV 89106-2144 | 2019-08-05 |
| 1952955130 | Rey Leonardo Garcia Moreno | Technician | 1951 Stella Lake St Ste 36, Las Vegas, NV 89106-2144 | 2019-07-26 |
| 1548813629 | Zena Kay Tennison | Technician | 1951 Stella Lake St Ste 36, Las Vegas, NV 89106-2144 | 2019-07-18 |
| 1285287466 | Maria E Alvizures | Technician | 1951 Stella Lake St Ste 36, Las Vegas, NV 89106-2144 | 2019-07-17 |
| 1215598925 | Audrey Mae Richards | Technician | 1951 Stella Lake St Ste 36, Las Vegas, NV 89106-2144 | 2019-06-24 |
| 1174182547 | Francisca Esther Hernandez-fernandez | Technician | 1951 Stella Lake St Ste 36, Las Vegas, NV 89106-2144 | 2019-06-10 |
| 1285293571 | Gisela Caridad Fernandez | Technician | 1951 Stella Lake St Ste 36, Las Vegas, NV 89106-2144 | 2019-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555772 | Graciela Miranda Cocorpio | Technician | 820 Rancho Ln Suite #40, Las Vegas, NV 89106 | 2020-10-09 |
| 1679101679 | A Better You Wellness Center | Counselor | 320 W Monroe Street, Las Vegas, NV 89106 | 2020-03-27 |
| 1730725177 | Mariah La'neese Jones | Rehabilitation Practitioner | 400 Shadow Lane Ste 106, Las Vegas, NV 89106 | 2019-11-20 |
| 1417592841 | Lourdes Rita Apumayta-paredes | Technician | 820 Rancho Lane, Suite #40, Las Vegas, NV 89106 | 2019-11-08 |
| 1902456551 | Marisela Pena | Technician | 820 Rancho Ln., 25, Las Vegas, NV 89106 | 2019-09-16 |
| 1992368724 | Amber Nicole Mahajan | Nurse Practitioner | 2020 Wellness Way, Suite 300, Las Vegas, NV 89106 | 2019-04-17 |
| 1568924215 | Arlandrea Tarvins | Behavioral Analyst | 1048 Miller Ave, Las Vegas, NV 89106 | 2019-04-02 |
| 1427510361 | Erik Pennell | Student in an Organized Health Care Education/Training Program | 1542 Pinto Ln, 2nd Floor, Las Vegas, NV 89106 | 2019-04-01 |
| 1245702729 | Bruce Mark Babb | Technician | 820 Rancho Lane Ste #40, Las Vegas, NV 89106 | 2018-12-21 |
| 1639649213 | Antonio Ruiz Pelfort | Technician | 1951 Stella Lake St Suite 36, Las Vegas, NV 89106 | 2018-11-27 |
| Find all providers in zip 89106 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396628 | Jill Azevedo | Technician | 6300 Black Mesa Ct, Las Vegas, NV 89142-7919 | 2020-11-06 |
| 1396346409 | Johanna Dwyer | Technician | 5755 E Lake Mead Blvd Apt D, Las Vegas, NV 89156-6859 | 2020-11-04 |
| 1063013274 | Lloyd Major | Technician | 3830 University Center Dr Apt 318, Las Vegas, NV 89119-7420 | 2020-11-04 |
| 1861093239 | Raiquave Morgan | Technician | 5256 Tamarus St Apt B, Las Vegas, NV 89119-5047 | 2020-11-03 |
| 1669073250 | Chrissy Bowser | Technician | 3355 Spg Mnt Rd Ste 67, Las Vegas, NV 89102-8633 | 2020-11-02 |
| 1235739392 | Maxima Del Carmen Garcia | Technician | 3580 E Alexander Rd Apt 2016, Las Vegas, NV 89115 | 2020-10-28 |
| 1427657196 | Hector Querubin | Technician | 5400 S Maryland Pkwy Apt 165, Las Vegas, NV 89119-2642 | 2020-10-22 |
| 1043819063 | Ma Guadalupe Ramos Michel | Technician | 2415 Reynolds Ave #101, Las Vegas, NV 89030 | 2020-10-21 |
| 1881293777 | Miguel Angel Umpierre | Technician | 9889 Overlook Ridge Ave, Las Vegas, NV 89148 | 2020-10-21 |
| 1356940654 | Shannon Gordon | Technician | 1224 W Lake Mead Blvd, Las Vegas, NV 89106-2415 | 2020-10-19 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.