Terrence Terrell Jackson

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

LA9563 Issued in LA

Practice address

1240 Southampton Dr
Alexandria, LA 71303-3035

Phone

(318) 792-8400

NPI assigned

Jul 27, 2022

Last updated

Jul 27, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1013643535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 SOUTHAMPTON DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033035",
            "telephone_number": "318-792-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 SOUTHAMPTON DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033035",
            "telephone_number": "318-792-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 Versailles Blvd",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "LA",
            "postal_code": "713032327",
            "country_code": "US",
            "telephone_number": "318-321-1790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TERRENCE",
        "middle_name": "TERRELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "LA",
            "license": "LA9563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "melanoticmassage@gmail.com",
            "affiliation": "N",
            "address_1": "703 Versailles Blvd",
            "city": "Alexandria",
            "state": "LA",
            "country_code": "US",
            "postal_code": "713032327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Racine Dominique Jackson, NP
• Ralph Dudley Jackson III, D.D.S.
• Rita Jackson, RSW
• Ronnie Jackson
• Shadiamond Jackson
• Tonya Sue Jackson, PH.D.
• Billyona Jacobs, MHS
• Felicia Yaquita Jacobs, MHT
• Naseem A Jaffrani, M.D.
• James a. White, III, M.D., Apmc

• Massage Therapist in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Massage Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.