Robert Lee Knapp Jackson

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

License

SLPA14215 Issued in AZ

Practice address

11226 N 23Rd Ave Ste 101
Phoenix, AZ 85029-4830

Phone

(602) 309-8821

NPI assigned

Jan 9, 2023

Sex

Male

Sole proprietor

Yes

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

Practice roles

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.

• Green Apple Kids Therapy LLC

  • Speech-Language Pathologist
  • Glendale, AZ
  • NPI 1265350011

  Speech-Language Assistant

  NPD (past) Authorized official

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1134833759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23634 N 58TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853103647",
            "telephone_number": "602-309-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11226 N 23RD AVE STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294830",
            "telephone_number": "602-309-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ROBERT LEE",
        "middle_name": "KNAPP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "SLPA14215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Aleece Jackson, M.A. CCC-SLP
• Parker Jackson
• Paul D Jackson, LCSW
• Regula R. Jackson, CNM, OB-GYN NP
• Rick Jackson
• Sam Jackson, M.D.
• Sherika Marchelle Jackson, LCSW, LCASA
• Takira C. Jackson, LAC
• Tonie Jonee Jackson
• Toniyah Vernae Jackson

• Speech-Language Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Speech-Language Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.

Verify at the official NPI Registry.