Dr. Katie Jackson'S Wound, Ostomy and Footcare

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

Organization subpart

No

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

Authorized official

Name

Katie Jackson, PT

Title

PT, Owner

Phone

(978) 821-0842

Specialties & licenses 2

Addresses

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": []
}

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• Physical Therapist in Massachusetts

• 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.