Keith T. Jackson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT45012 Issued in FL

Practice address

2155 Everglades LN
The Villages, FL 32163-1037

Phone

(352) 492-3048

Fax

(352) 547-4024

NPI assigned

Jul 29, 2019

Last updated

Sep 18, 2026By the provider in NPPES

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)

Enrolled

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789689600000",
    "number": "1184278129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 EVERGLADES LN",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321631040",
            "telephone_number": "352-492-3048",
            "fax_number": "352-547-4024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 EVERGLADES LN",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321631037",
            "telephone_number": "352-492-3048",
            "fax_number": "352-547-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KEITH",
        "middle_name": "T.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-29",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT45012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace E Ireland, MSW
• Sara Ishaq
• Kerling Israel, MD
• Reem Jaber, D.M.D.
• Tina M Jackovich, MA CCC/SLP-L
• Vickie L Jackson
• Paula Marie Jacobsen, APRN
• Jad Jaffal, D.M.D
• Burton S Jaffe, M.D.
• Thumati G Jagalur, MD

• Physical Therapist in The Villages, FL
• Providers in The Villages, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; 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.