Aaron Jackson

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT007326 Issued in PA

Practice address

1220 N Broad St
Philadelphia, PA 19121-5139

Phone

(917) 283-8967

NPI assigned

Dec 5, 2018

Sex

Male

Sole proprietor

No

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

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1164992947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11346 194TH ST",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114122424",
            "telephone_number": "917-283-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191215139",
            "telephone_number": "917-283-8967"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11346 194th St",
            "address_purpose": "LOCATION",
            "city": "Saint Albans",
            "state": "NY",
            "postal_code": "114122424",
            "country_code": "US",
            "telephone_number": "917-283-8967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "AARON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-05",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT007326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aja Jackson Devose, D.O.
• Tracy P Jackson-Bunn, RN
• Maya Jackson-Gibson
• A'Taja Jackson
• Aaron Jackson, DO, DPT
• Alyce Jackson, PH.D.
• Amanda Emily Jackson, C.R.N.P
• Andrea Arnita Jackson, CRNP
• Andrea L Jackson, CRNP
• Anita Marie Jackson, LPN

• Athletic Trainer in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2019; 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.