Active NPI
Jabria Jackson, SLP
- Speech-Language Pathologist
- Marietta, GA
National Provider Identifier
1063162535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP012051
- Practice address
- 1822 Powder Springs Rd SW
Marietta, GA 30064-4886 - Phone
- (803) 634-5959
- NPI assigned
- Mar 26, 2022
- Last updated
- May 22, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP012051 | GA | Primary |
| Speech-Language Pathologist | 235Z00000X |
Addresses
Primary practice location
1822 Powder Springs Rd SW
Marietta, GA 30064-4886
Mailing address
1822 Powder Springs Rd SW
Marietta, GA 30064-4886
Phone (803) 634-5959
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 |
|---|---|---|---|
| SLP012051 | GA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| World of Therapeutics, LLC | Multi-Specialty | Current | Accepting new patients |
| Rehabcare Group East, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684713600000",
"number": "1063162535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1822 POWDER SPRINGS RD SW",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300644886",
"telephone_number": "803-634-5959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1822 POWDER SPRINGS RD SW",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300644886",
"telephone_number": "803-634-5959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JABRIA",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-03-26",
"last_updated": "2023-05-22",
"certification_date": "2023-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP012051",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.