Teresa B Jackson, HIS

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

25MG00116200 Issued in NJ

Practice address

2001 Lincoln Dr W
Suite E
Marlton, NJ 08053-1531

Phone

(856) 596-9670

Fax

(856) 985-6302

NPI assigned

Oct 8, 2012

Last updated

Feb 28, 2019By 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 2

Addresses

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": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1245582741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 WASHINGTON AVE S",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443405",
            "telephone_number": "612-351-1529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 LINCOLN DR W",
            "address_2": "SUITE E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531531",
            "telephone_number": "856-596-9670",
            "fax_number": "856-985-6302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TERESA",
        "middle_name": "B",
        "credential": "HIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "NJ",
            "license": "25MG00116200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monisha Iyer, DMD
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• Amira Jabbar
• Edelquinne Ann Jacildo
• Danielle Marie Jacobs
• Samantha Raven Jaconetti
• Brian Jaffe, MD
• Yvette Jamison, LSW
• Steven Janik, ATC

• Hearing Instrument Specialist in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Hearing Instrument Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.