Michaela L Jackson, A.T.C

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

105 Ashland Ave
Clinton, SC 29325-2960

Phone

(864) 833-7098

NPI assigned

Oct 27, 2016

Sex

Female

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

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

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1154873057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 WOODHAVEN CT SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300943951",
            "telephone_number": "770-375-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 ASHLAND AVE",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "293252960",
            "telephone_number": "864-833-7098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MICHAELA",
        "middle_name": "L",
        "credential": "A.T.C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-27",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronica McCanty Hunter, FNP-C
• Loghman Huseynov, MD
• Akhtar Hussain, M.D.
• Chelsey Anne Hyatt, PTA
• Integrative Healthcare Solutions LLC
• Ashley Jane Jenkins, M.D.
• Michael Burton Jenkins, M.D.
• Elizabeth C Johnson
• Nelson Jones
• Zachary R Jones, PHARMD

• Student in an Organized Health Care Education/Training Program in Clinton, SC
• Providers in Clinton, SC by specialty
• Student in an Organized Health Care Education/Training Program in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; 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.