Active NPI
Erika Jackson, PT
- Physical Therapist
- Houston, TX
National Provider Identifier
1205674652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1261841
- Practice address
- 609 Waverly St
Unit 453
Houston, TX 77007-4515 - Phone
- (240) 695-2884
- Fax
- (929) 290-0328
- NPI assigned
- Jul 18, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 1261841 | TX | Primary |
Addresses
Primary practice location
609 Waverly St
Unit 453
Houston, TX 77007-4515
Mailing address
609 Waverly St Apt 453
Houston, TX 77007-4515
Phone (240) 695-2884
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 |
|---|---|---|---|
| 1261841 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721260800000",
"number": "1205674652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "609 WAVERLY ST APT 453",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770074515",
"telephone_number": "240-695-2884",
"fax_number": "929-290-0328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "609 WAVERLY ST",
"address_2": "UNIT 453",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770074515",
"telephone_number": "240-695-2884",
"fax_number": "929-290-0328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "ERIKA",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-18",
"last_updated": "2024-07-18",
"certification_date": "2024-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "TX",
"license": "1261841",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.