Natalie Aleece Jackson, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22004557A Issued in IN

Practice address

7540 N 19TH Ave Ste 200
Phoenix, AZ 85021-7967

Phone

(888) 873-4221

Fax

(888) 543-2289

NPI assigned

Dec 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Merrillville, IN
  • NPI 1053833657

  Speech-Language Pathologist

  Medicare reassignment NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1164605697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6589 W STONES CROSSING RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461439117",
            "telephone_number": "214-223-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7540 N 19TH AVE STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850217967",
            "telephone_number": "888-873-4221",
            "fax_number": "888-543-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "NATALIE",
        "middle_name": "ALEECE",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-06",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22004557A",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "19716",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynetta Jean Jackson
• Mac Roy Jackson III, DMD
• Marlene Jackson, SLPA
• Melissa Reyes Jackson, M.ED
• Nannie Jackson
• Parker Jackson
• Paul D Jackson, LCSW
• Regula R. Jackson, CNM, OB-GYN NP
• Rick Jackson
• Robert Lee Knapp Jackson

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.