Michele D Jackson, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00009603 Issued in WA

Practice address

27005 Pacific Hwy S
Des Moines, WA 98198-9250

Phone

(253) 839-9280

NPI assigned

Sep 13, 2006

Last updated

Feb 7, 2022By the provider in NPPES

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 4

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Multicare Health SystemGroup PAC ID 7719899897, shared by 46 NPIs, 2,312 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Physiotherapy Associates, Inc.

  dba Select Physical Therapy

  • Physical Therapist
  • Kirkland, WA
  • NPI 1497211049
  Medicare reassignment NPD
• Physiotherapy Associates, Inc.

  • Physical Therapy Clinic/Center
  • Redmond, WA
  • NPI 1780140335

  Physical Therapist

  NPD
• Physiotherapy Associates Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Estero, FL
  • NPI 1720039902
  NPD

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1033214291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27005 PACIFIC HWY S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981989250",
            "telephone_number": "253-839-9280",
            "fax_number": "253-839-9375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27005 PACIFIC HWY S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981989250",
            "telephone_number": "253-839-9280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MICHELE",
        "middle_name": "D",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00009603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8413668",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00303497",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR & INDUSTRY",
            "identifier": "0197668",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0296927",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Xavier Inac Ibarreta, DC
• Emily Kimiko Ikebe, OTR
• Im&G PLLC
• Jesus Iniguez, MD
• John Thomas Jackson, LMP
• Janis Ann Jacobson, L.M.P.
• Dena Rene Johnson, LMHC
• Juanita Lee Johnson, RDH
• Magdalena Johnson, MSW
• Melissa Ann Gaytan Johnson, LMHCA CN

• Physical Therapist in Des Moines, WA
• Providers in Des Moines, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; 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.