CMS-1500 Box 24J / 33a • NPI
1215797410
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
343900000X
Licensed & Credentialed Non-emergency Medical Transport (VAN)
Box 32 Service Location & ZIP+4
333 W BROWN DEER RD UNIT G-855, BAYSIDE, WI, 53217-2372
✓ 9-Digit EDI 837 ZIP+4 (53217-2372)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1215797410 (STEPHANIE JACKSON) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1215797410 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | STEPHANIE JACKSON |
| Plain-English Specialty | Licensed & Credentialed Non-emergency Medical Transport (VAN) NUCC Code: 343900000X (Non-emergency Medical Transport (VAN)) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 333 W BROWN DEER RD UNIT G-855, BAYSIDE, WI, 53217-2372 |
| Practice Telephone / Fax | Tel: (414) 719-0055 |
| Administrative Mailing Address | 333 W BROWN DEER RD UNIT G-855, BAYSIDE, WI, 53217-2372 |
| Enumeration & Last Sync | Enumerated: 2024-03-22 | CMS Record Updated: 2024-03-22 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (343900000X)
What Does Taxonomy Code 343900000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 343900000X translates to:
"Licensed & Credentialed Non-emergency Medical Transport (VAN)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (STEPHANIE JACKSON)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
343900000X — Non-emergency Medical Transport (VAN)Plain English: Licensed & Credentialed Non-emergency Medical Transport (VAN) | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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