Ladonya Jackson, PhD
Student in an Organized Health Care Education/Training Program in Boston, MA. Individual provider (NPI-1).
Details
- NPI
- 1194474049
- Entity type
- Individual (NPI-1)
- Name
- Ladonya Jackson
- Credential
- PhD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 19, 2022
- Certification date
- Mar 18, 2023
- Last updated
- Mar 18, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
55 Fruit StBoston, MA 02114-2621
Phone 617-726-2000
Mailing address
1120 15th StAugusta, GA 30912-0004
Phone 408-300-4456
Other practice locations
Augusta, GA 30912-0004
Phone 408-300-4456
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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