John Martin Jackson

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2306602301 Issued in VA

Practice address

11118 Lantern Way
North Chesterfield, VA 23236-3575

Phone

(646) 408-0535

NPI assigned

Feb 5, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1517788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517788800000",
    "number": "1063911105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7523",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232310023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11118 LANTERN WAY",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232363575",
            "telephone_number": "646-408-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JOHN",
        "middle_name": "MARTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-05",
        "last_updated": "2018-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306602301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elden Paul Iverson, MD
• J&M Adult Care Services, LLC
• Angelette Jackson, NP
• Emily Jackson
• Hannah Kioko Jackson
• Naomi Martina Jackson, LCSW
• Quatysha N Jackson, LCSW
• Harvey Earl Jacobs, PH.D.
• Rebecca Jacobson-Fowler, LMT
• Joseph Jadallah, PHARMD

• Physical Therapy Assistant in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; 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.