Jacquelyn L. Eaton, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

14-01828 Issued in KS

Practice address

600 Perry St
Rossville, KS 66533-9784

Phone

(785) 584-6968

Fax

(785) 584-6005

NPI assigned

Aug 16, 2010

Last updated

Dec 22, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jackie L. Eaton Professional name

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": "1281916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419206400000",
    "number": "1235444100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 PERRY ST",
            "city": "ROSSVILLE",
            "state": "KS",
            "postal_code": "665339784",
            "telephone_number": "785-584-6968",
            "fax_number": "785-584-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PERRY ST",
            "city": "ROSSVILLE",
            "state": "KS",
            "postal_code": "665339784",
            "telephone_number": "785-584-6968",
            "fax_number": "785-584-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "JACQUELYN",
        "middle_name": "L.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-16",
        "last_updated": "2014-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KS",
            "license": "14-01828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "EATON",
            "middle_name": "L.",
            "credential": "PTA / MCST",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Physical Therapy Assistant in Rossville, KS
• Providers in Rossville, KS by specialty
• Physical Therapy Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; 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.