TEDRA JACKSON NPI 1255211447

NPI Information

NPI: 1255211447
Provider Name: TEDRA JACKSON
Classification: Technician - 3747P1801X
Specialization: Personal Care Attendant
Entity Type: Individual
Address: 782 E 130TH ST
CLEVELAND, OH
ZIP 44108
Phone: (216) 334-3163

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NPI Details

Tedra Jackson is a personal care attendant technician in Cleveland, OH. The provider is an individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards Tedra Jackson NPI is 1255211447. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

782 E 130TH ST
CLEVELAND, OH
ZIP 44108-544
Phone: (216) 334-3163

The enumeration date for this NPI number is 9/8/2025 and was last updated on 9/8/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	251C00000X	Day Training, Developmentally Disabled Services		OHIO	No
2	251X00000X	Supports Brokerage		OHIO	No
3	253Z00000X	In Home Supportive Care		OHIO	No
4	332U00000X	Home Delivered Meals		OHIO	No
5	3747P1801X	Technician	Personal Care Attendant	OHIO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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