Michael Frank Jackson Jr., DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT013016 Issued in GA

Practice address

1806 Russell Pkwy Ste 1400
Warner Robins, GA 31088-5781

Phone

(478) 235-4441

NPI assigned

Jul 31, 2017

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)

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 and National Provider Directory roles.

• Back in Action Physical Therapy & Performance LLC

  • Physical Therapy Clinic/Center
  • Warner Robins, GA
  • NPI 1386240364
  NPD Authorized official
• Totem Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Warner Robins, GA
  • NPI 1487260840
  NPD Authorized official
• R. Jason Kent Physical Therapy

  • Physical Therapist
  • Macon, GA
  • NPI 1710473921
  NPD (past)

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1114441375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 PARTRIDGE TRL",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310886592",
            "telephone_number": "478-333-3075",
            "fax_number": "478-333-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 RUSSELL PKWY STE 1400",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310885781",
            "telephone_number": "478-235-4441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Osigian Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310888978",
            "country_code": "US",
            "telephone_number": "478-333-3075",
            "fax_number": "478-333-3484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MICHAEL",
        "middle_name": "FRANK",
        "name_suffix": "Jr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-31",
        "last_updated": "2022-07-21",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT013016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hunter Curtis Jackson, AGACNP
• Kathryn Elizabeth Jackson
• Latoya Danielle Jackson, D.O.
• Leticia Jackson
• Mark Jackson Jr.
• Princess Jackson
• Shekia Bowens Jackson, OTHER
• Tammy Christy Jackson, MEDICAL ASSISTANT
• Teri Jackson, AGNP-C
• Tiera Jackson, MS

• Physical Therapist in Warner Robins, GA
• Providers in Warner Robins, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.