Active NPI
Kenley Brooke Jackson, PT, DPT
- Physical Therapist
- Little Rock, AR
National Provider Identifier
1194543223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT5545
- Practice address
- 1500 N Mississippi St
Little Rock, AR 72207-5851 - Phone
- (501) 217-8600
- Fax
- (501) 217-8636
- NPI assigned
- Sep 27, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT5545 | AR | Primary |
Addresses
Primary practice location
1500 N Mississippi St
Little Rock, AR 72207-5851
Mailing address
10618 Breckenridge Dr
Little Rock, AR 72211-1802
Phone (501) 217-8600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT5545 | AR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCT, Inc. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742947200000",
"number": "1194543223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10618 BRECKENRIDGE DR",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722111802",
"telephone_number": "501-217-8600",
"fax_number": "501-217-8636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 N MISSISSIPPI ST",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722075851",
"telephone_number": "501-217-8600",
"fax_number": "501-217-8636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "KENLEY",
"middle_name": "BROOKE",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-27",
"last_updated": "2025-03-26",
"certification_date": "2025-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "PT5545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.