Kelly Christine Jackson-Doebler, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

012059-1 Issued in NY

Practice address

6 Johnston St
Seneca Falls, NY 13148-1206

Phone

(315) 568-2476

Fax

(315) 568-8958

NPI assigned

Oct 23, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Kelly Christine Jackson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1224720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224720000000",
    "number": "1013160837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 JOHNSTON ST",
            "city": "SENECA FALLS",
            "state": "NY",
            "postal_code": "131481206",
            "telephone_number": "315-568-2476",
            "fax_number": "315-568-8958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 JOHNSTON ST",
            "city": "SENECA FALLS",
            "state": "NY",
            "postal_code": "131481206",
            "telephone_number": "315-568-2476",
            "fax_number": "315-568-8958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON-DOEBLER",
        "first_name": "KELLY",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-23",
        "last_updated": "2008-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "012059-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "JACKSON",
            "middle_name": "CHRISTINE",
            "prefix": "MISS",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Connie S Hodde, LMT
• Dennis MJ Homack, DC, MS, CCSP
• Edward Paul House, DC,PT
• Mark L Hylwa, RPH
• Georgios Ioannidis, D.C
• Francesca Jacobs, NP-C
• Kelly Jacuzzo, CCC-SLP
• Jeffrey a Vernon, DO, PLLC
• Jennifer L Stanton DC (Stanton Chiropractic)
• Joseph Jeon, D.C.

• Physical Therapist in Seneca Falls, NY
• Providers in Seneca Falls, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; 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.