Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1629380316 Individual Practitioner Female Practitioner

Kennie Nicole Jackson

Driver • Indianapolis, IN

Professional Overview & Biography Verified Profile Summary

Kennie Jackson is a registered healthcare professional specializing in Driver in Indianapolis, IN. Practice services are available at 315 PALMYRA DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

315 Palmyra Dr

Indianapolis, IN 462399170

Telephone 3179090320

Specialty Benchmarks & Practice Insights

Comparative analytics for Driver in Indianapolis, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
55 Specialists

Practicing in Indianapolis, IN (139 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-08-19
Driver Primary Specialty

NUCC Taxonomy Code: 172A00000X

State License IN 2400290281

A person employed to operate a motor vehicle as a carrier of persons or property.

Adult Companion

NUCC Taxonomy Code: 372600000X

An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care.

Homemaker

NUCC Taxonomy Code: 376J00000X

An individual who provides general household activities such as meal preparation, laundry, and light housekeeping, when the individual regularly responsible for these activities is temporarily absent or unable to provide for himself. Homemakers must meet the state defined training standards.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location August 19, 2024

Registered at 315 PALMYRA DR, INDIANAPOLIS, IN 462399170 (Tel: 3179090320)

📍
Updated Business Mailing Address August 19, 2024

Registered at 315 PALMYRA DR, INDIANAPOLIS, IN 462399170 (Tel: 7652275006)

👤
Provider Name / Credentials Updated August 19, 2024

Recorded as KENNIE JACKSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 19, 2024

Adult Companion

NPI Profile Active July 09, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location July 09, 2010

Registered at 3955 CAMPBELL AVE, INDIANAPOLIS, IN 462264836 (Tel: 3173623792)

📍
Updated Business Mailing Address July 09, 2010

Registered at 3955 CAMPBELL AVE, INDIANAPOLIS, IN 462264836 (Tel: 3173623792)

👤
Provider Name / Credentials Updated July 09, 2010

Recorded as KENNIE WALCOTT

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2010

Technician

🟢
Initial NPI Registration & Enumeration July 09, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1629380316
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 09, 2010
Last Update: August 19, 2024
Sole Proprietor: No

Mailing Address

315 Palmyra Dr

Indianapolis, IN 462399170

Phone: 7652275006

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.