What is Latrese Jackson's NPI number?

Latrese Jackson's National Provider Identifier (NPI) is 1295316511, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.

What is Latrese Jackson's specialty?

Latrese Jackson is listed in the NPPES registry with a primary specialty of Prosthetic/Orthotic Supplier (Suppliers).

Where is Latrese Jackson located?

Latrese Jackson's practice location on file with NPPES is 2324 Gwendale Dr W, Lizella, GA 31052-3550.

What is Latrese Jackson's phone number?

The practice phone number listed in the NPPES registry for Latrese Jackson is (478) 250-4601.

Is Latrese Jackson's NPI active?

Yes — Latrese Jackson's NPI (1295316511) is active in the NPPES registry as of the last update on 2021-04-19.

IndividualActive

Latrese Jackson

NPI 1295316511 · Prosthetic/Orthotic Supplier · Lizella, GA

Latrese Jackson is a Prosthetic/Orthotic Supplier provider in Lizella, GA (NPI 1295316511).

Provider details

NPI number: 1295316511
Entity type: Individual
Primary specialty: Prosthetic/Orthotic SupplierSuppliers
Sex: Female
Sole proprietor: Yes

Specialties & taxonomies

Prosthetic/Orthotic SupplierPrimary335E00000X
Suppliers

Profile Score

Established profile(56/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
5 yrs in NPPES registry
Profile completeness38% of score
83% of core fields populated
Practice footprint23% of score
1 documented practice location

Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

Practice location

2324 Gwendale Dr W

Lizella, GA 31052-3550

Phone: (478) 250-4601

Street-level locationGet directions

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Mailing address