Alicia Ladonna Jackson, PT

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

3630 Northbrook Dr
Northport, AL 35473-5822

Phone

(205) 330-1001

NPI assigned

Dec 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of South Alabama College of Medicine, 1994

Medicare assignment

May accept Medicare assignment

Group practices

DCH Encore Rehabilitation, LLCGroup PAC ID 1759621295, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• DCH Encore Rehabilitation, LLC

  • Physical Therapist
  • Northport, AL
  • NPI 1669942728

  AL

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013071745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4206 REVERE WAY",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354754421",
            "telephone_number": "205-330-0642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 NORTHBROOK DR",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735822",
            "telephone_number": "205-330-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ALICIA",
        "middle_name": "LADONNA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "9712",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Infectious Disease&Allergy
• Octavia Ingram, DNP, FNP-C, PMHNP-BC
• Innovative Health Practice Center, LLC
• Brock Isom
• Raychelle Ivie, CPHT
• David B Jackson, MD
• Lindsey Sexton Jackson, CRNP
• William Jacobs, DPT
• Ashok Jagani, MD
• James River SCLH

• All providers in Northport, AL
• Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.