Tara Jackson, M.ED.

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

260 Peachtree St NW Ste 2200
Atlanta, GA 30303-1292

Phone

(404) 931-4220

NPI assigned

Jul 6, 2016

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471996800000",
    "number": "1184076812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 FAIRWAY DR STE 102",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334411817",
            "telephone_number": "888-880-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 PEACHTREE ST NW STE 2200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303031292",
            "telephone_number": "404-931-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TARA",
        "credential": "M.ED.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2016-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephane Lea Jackson, LMT, CCT
• Sunny Michele Jackson
• Taneisha Chree Jackson
• Tanjela M Jackson, MD
• Tanya Tamara Jackson, APRN
• Taylor Jackson, DC
• Taylor Simone Jackson
• Tiphani Jackson, PT, DPT, ATC
• Todd Jackson Jr., MD, MPH
• Troya Lusand Jackson, LMSW

• Developmental Therapist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Developmental Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.