Karen C. Jackson, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202004751 Issued in VA

Practice address

7449 Heatherfield LN
Alexandria, VA 22315-5292

Phone

(724) 413-4024

Fax

(703) 822-0063

NPI assigned

Jul 11, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

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": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1194013284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7449 HEATHERFIELD LN",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223155292",
            "telephone_number": "724-413-4024",
            "fax_number": "703-822-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7449 HEATHERFIELD LN",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223155292",
            "telephone_number": "724-413-4024",
            "fax_number": "703-822-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KAREN",
        "middle_name": "C.",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202004751",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL004095",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "007838",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emmanuel Jackson
• Faiza Omer Jackson, LCSW
• Gina Diane Jackson, PA-C
• Gina Lori Jackson, RN
• James Jackson, COTA/L
• Kevin D Jackson, D.D.S.
• Kiera A Jackson
• Lawrence Phillip Jackson III
• Makeda Jackson, OTD, OTR/L
• Marsha E Jackson, CNM

• Speech-Language Pathologist in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; 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.