Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Catherine Alisa Jackson

Individual provider Gerontology Nurse Practitioner · NPI 1215612031

Catherine Alisa Jackson is a Nurse Practitioner in Kettering, Ohio. Qualified in 2022, 4 years ago. Practices with Namchi Le MD LLC, a 4-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
4
Licensed in
OH
In the registry since
2023

Practice location Address checks out

3535 Southern Blvd
Kettering, OH 45429-1221
Phone: (937) 298-4331
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence APRN.CNP.0034084 (OH)

Record details

NPI number1215612031
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 19, 2023
Last updated in NPPESJanuary 25, 2024
Certification dateJanuary 25, 2024
Mailing address3535 Southern Blvd, Kettering, OH 45429-1221

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Namchi Le Md Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Kettering