Active NPI
Vanessa Louise Jackson, OTR
- Occupational Therapist
- Easley, SC
National Provider Identifier
1235748161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5609
- Practice address
- 1348 Griffin Mill Rd
Easley, SC 29640-8885 - Phone
- (864) 397-1000
- Fax
- (864) 855-8159
- NPI assigned
- Jul 27, 2020
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5609 | SC | Primary |
Addresses
Primary practice location
1348 Griffin Mill Rd
Easley, SC 29640-8885
Mailing address
316 Walden Creek Way
Greenville, SC 29615-6713
Phone (334) 707-6998
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 |
|---|---|---|---|
| 5609 | SC | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| School District of Pickens County | 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.
-
- Local Education Agency (LEA)
- Easley, SC
- NPI 1790711083
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595808000000",
"number": "1235748161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "316 WALDEN CREEK WAY",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296156713",
"telephone_number": "334-707-6998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1348 GRIFFIN MILL RD",
"city": "EASLEY",
"state": "SC",
"postal_code": "296408885",
"telephone_number": "864-397-1000",
"fax_number": "864-855-8159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "VANESSA",
"middle_name": "LOUISE",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-27",
"last_updated": "2020-07-27",
"certification_date": "2020-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "SC",
"license": "5609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Easley, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.