Active NPI
Deasia Jackson
- Speech-Language Pathologist
- Mobile, AL
National Provider Identifier
1114605342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5345
- Practice address
- 3712 Dauphin St
Mobile, AL 36608-1725 - Phone
- (251) 304-3000
- NPI assigned
- Jul 7, 2023
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 5345 | AL | Primary |
Addresses
Primary practice location
3712 Dauphin St
Mobile, AL 36608-1725
Mailing address
245 Cahaba Valley Pkwy
Pelham, AL 35124-2216
Phone (205) 942-6820
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688688000000",
"number": "1114605342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 CAHABA VALLEY PKWY",
"city": "PELHAM",
"state": "AL",
"postal_code": "351242216",
"telephone_number": "205-942-6820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3712 DAUPHIN ST",
"city": "MOBILE",
"state": "AL",
"postal_code": "366081725",
"telephone_number": "251-304-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "DEASIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-07",
"last_updated": "2023-07-07",
"certification_date": "2023-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AL",
"license": "5345",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.