Active NPI
Melissa Kae Jackson, PT
- Physical Therapist
- Saratoga Springs, NY
National Provider Identifier
1043324866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0183161
- Practice address
- 131 Lawrence St
Outpatient Therapies
Saratoga Springs, NY 12866-1346 - Phone
- (518) 691-1451
- Fax
- (518) 691-1460
- NPI assigned
- Aug 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 0183161 | NY | Primary |
Addresses
Primary practice location
131 Lawrence St
Outpatient Therapies
Saratoga Springs, NY 12866-1346
Mailing address
131 Lawrence St
Outpatient Therapies
Saratoga Springs, NY 12866-1346
Phone (518) 691-1451
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0183161 | NY | MD | Physical Therapist |
| 018316 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043324866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 LAWRENCE ST",
"address_2": "OUTPATIENT THERAPIES",
"city": "SARATOGA SPRINGS",
"state": "NY",
"postal_code": "128661346",
"telephone_number": "518-691-1451",
"fax_number": "518-691-1460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 LAWRENCE ST",
"address_2": "OUTPATIENT THERAPIES",
"city": "SARATOGA SPRINGS",
"state": "NY",
"postal_code": "128661346",
"telephone_number": "518-691-1451",
"fax_number": "518-691-1460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "MELISSA",
"middle_name": "KAE",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "0183161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saratoga Springs, NY
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.