Active NPI
Eric Winfred Jackson, R.P.T.
- Physical Therapist
- New Orleans, LA
National Provider Identifier
1164510202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 06827R
- Practice address
- 3662 Inwood Avenue
New Orleans, LA 70131 - Phone
- (504) 813-5065
- Fax
- (504) 282-4407
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 06827R | LA | Primary |
Addresses
Primary practice location
3662 Inwood Avenue
New Orleans, LA 70131
Mailing address
3662 Inwood Avenue
New Orleans, LA 70131
Phone (504) 813-5065
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06827R | LA | MD | Therapeutic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406678400000",
"number": "1164510202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3662 INWOOD AVENUE",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "70131",
"telephone_number": "504-813-5065",
"fax_number": "504-282-4407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3662 INWOOD AVENUE",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "70131",
"telephone_number": "504-813-5065",
"fax_number": "504-282-4407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "ERIC",
"middle_name": "WINFRED",
"credential": "R.P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2014-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "06827R",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Orleans, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.