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Deactivated NPI 1265711105 Deactivated / Inactive NPI Female Practitioner

Nichole Jackson , LPN

Licensed Practical Nurse • Elyria, OH

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Nichole Jackson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 10, 2011
NPI Deactivation Date March 12, 2026
Total Practice Duration ~15 Years of Practice (2011 – 2026)

Professional Overview & Biography Verified Profile Summary

Nichole Jackson, LPN was a registered Licensed Practical Nurse practicing in Elyria, OH. Throughout an active medical career spanning 15 years, Nichole Jackson provided care at the practice location at 224 GEORGE ST until profile deactivation on 2026-03-12.

Practice Location & Contact Primary Location

Practice Address

224 George St

Elyria, OH 440357025

Telephone 4404529835

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Elyria, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.0 Yrs
Regional Practice Density
56 Specialists

Practicing in Elyria, OH (13034 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

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License OH PN.141786-M-IV

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated March 12, 2026

Record deactivated on March 12, 2026

NPI Profile Active August 10, 2011

NPI status registered as active in NPPES database

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Updated Practice Location August 10, 2011

Registered at 224 GEORGE ST, ELYRIA, OH 440357025 (Tel: 4404529835)

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Updated Business Mailing Address August 10, 2011

Registered at 224 GEORGE ST, ELYRIA, OH 440357025 (Tel: 4404529835)

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Provider Name / Credentials Updated August 10, 2011

Recorded as NICHOLE JACKSON, L.P.N.

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 10, 2011

Licensed Practical Nurse (License #PN.141786-M-IV in OH)

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Initial NPI Registration & Enumeration August 10, 2011

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: 1265711105
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 10, 2011
Last Update: August 10, 2011
Deactivation Date: March 12, 2026

Mailing Address

224 George St

Elyria, OH 440357025

Phone: 4404529835

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.