NPIMap

Organization Active NPI

Dr. Katie Jackson's Wound, Ostomy and Footcare

  • Physical Therapist
  • Rutland, MA
National Provider Identifier
1003511908
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
DR. KATIE JACKSON'S WOUND, OSTOMY AND FOOTCARE
Practice address
179 Glenwood Rd
Rutland, MA 01543-1614
Phone
(978) 821-0842
NPI assigned
Apr 3, 2023
Last updated
Apr 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Katie Jackson, PTNPI 1619288495
Title
PT, Owner
Phone
(978) 821-0842

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Clinical Electrophysiology Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251E1300X

Addresses

Primary practice location

179 Glenwood Rd
Rutland, MA 01543-1614

Mailing address

16 Woodland Dr
Westminster, MA 01473-1132
Phone (978) 821-0842

Other practice location 1

16 Woodland Dr
Westminster, MA 01473-1132
Phone (978) 821-0842

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1003511908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 WOODLAND DR",
            "city": "WESTMINSTER",
            "state": "MA",
            "postal_code": "014731132",
            "telephone_number": "978-821-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 GLENWOOD RD",
            "city": "RUTLAND",
            "state": "MA",
            "postal_code": "015431614",
            "telephone_number": "978-821-0842"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16 Woodland Dr",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "MA",
            "postal_code": "014731132",
            "country_code": "US",
            "telephone_number": "978-821-0842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR. KATIE JACKSON'S WOUND, OSTOMY AND FOOTCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "PT, OWNER",
        "authorized_official_telephone_number": "978-821-0842",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251E1300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Electrophysiology, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.