NPIMap

Organization Active NPI

Jackson Therapy

  • Early Intervention Provider Agency
  • Gun Barrel City, TX
National Provider Identifier
1124421631
Registry record updated Sep 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
1249341 Issued in TX
Legal business name
JACKSON THERAPY
Practice address
849 S Gun Barrel LN # LM
Unit G5
Gun Barrel City, TX 75156-9335
Phone
(610) 737-2524
NPI assigned
Sep 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2014

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

Authorized official

Name
Samantha Moyer, DPT
Title
Physical Therapist
Phone
(610) 737-2524

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 1249341 TX Primary

Addresses

Primary practice location

849 S Gun Barrel LN # LM
Unit G5
Gun Barrel City, TX 75156-9335

Mailing address

849 S Gun Barrel LN # LM
Unit G5
Gun Barrel City, TX 75156-9335
Phone (610) 737-2524

National Provider Directory

National Provider Directory
Tax ID family
BCM Innovative Therapies2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1411948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411948800000",
    "number": "1124421631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 S GUN BARREL LN # LM",
            "address_2": "UNIT G5",
            "city": "GUN BARREL CITY",
            "state": "TX",
            "postal_code": "751569335",
            "telephone_number": "610-737-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 S GUN BARREL LN # LM",
            "address_2": "UNIT G5",
            "city": "GUN BARREL CITY",
            "state": "TX",
            "postal_code": "751569335",
            "telephone_number": "610-737-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-29",
        "last_updated": "2014-09-29",
        "status": "A",
        "authorized_official_last_name": "MOYER",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "610-737-2524",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "TX",
            "license": "1249341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gun Barrel City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; 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.