Pierce Jackson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

4345 Issued in AR

Practice address

204 Catherine St
Harrisburg, AR 72432-1100

Phone

(870) 578-0503

NPI assigned

Jun 15, 2022

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

Other identifiers 1

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": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1083344733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 CATHERINE ST",
            "city": "HARRISBURG",
            "state": "AR",
            "postal_code": "724321100",
            "telephone_number": "870-578-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 CATHERINE ST",
            "city": "HARRISBURG",
            "state": "AR",
            "postal_code": "724321100",
            "telephone_number": "870-578-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "PIERCE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "4345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA LICENSE NUMBER",
            "identifier": "4345",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://login.pointclickcare.com/home/userLogin.xhtml?_gl=1*geav64*_ga*ODE1OTUxOTAuMTY1NTMxMTk2MQ..*_ga_NBXHRQDSJE*MTY1NTMxMTk2MC4xLjAuMTY1NTMxMTk2MC42MA..&_ga=2.39029988.65490189.1655311961-81595190.1655311961&_gac=1.46052438.1655311961.Cj0KCQjwhqaVBhCxARIsAHK1tiPvt3Ne3k7NnzVNTkWYW1tB1tfVmWb3UENkuwT9LW1J6Xh-Vm4rk1saAh1IEALw_wcB",
            "affiliation": "N",
            "endpointDescription": "Point Click Care",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information",
            "address_1": "204 Catherine St",
            "city": "Harrisburg",
            "state": "AR",
            "country_code": "US",
            "postal_code": "724321100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lana Headley, APN
• Vonda Gale Houchin, MD
• Joni Croom Hutton, M.S.P. CCC/SLP
• Keely Imboden
• Natalie Kristene Jackson, CCC-SLP
• Let'S Talk Therapy LLC
• Lifeline Paramedics Inc
• Wanda Kay Linebarger, APN
• Bridgette L. Loggains, MCD, CCC-SLP
• Haley Jo Lovell

• All providers in Harrisburg, AR
• Physical Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.