Tiffany C Jackson, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA48935 Issued in FL

Practice address

6015 Chester Cir Ste 104
Jacksonville, FL 32217-2270

Phone

(904) 513-0453

NPI assigned

Jun 9, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Tiffany Jackson Other 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": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1235668450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 LAKE SHORE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322056484",
            "telephone_number": "904-428-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 CHESTER CIR STE 104",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172270",
            "telephone_number": "904-513-0453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TIFFANY",
        "middle_name": "C",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-09",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "48935",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA48935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "JACKSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sylvia H Jackson, PHARMD
• Tameatrice Michelle Jackson, RN/CRT
• Tasheka B Jackson
• Theresa E. Jackson
• Theresa Y Jackson, LMT
• Trichina Shalee Jackson
• Tyler Jackson
• Willie Jackson, BS
• Zamekio Jackson
• Jacksonville Accident and Sports Injury Center LLC

• Massage Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.

Verify at the official NPI Registry.