Active NPI
Huanne Jackson, OT
- Occupational Therapist
- Brevard, NC
National Provider Identifier
1255787248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 390
- Practice address
- 322 Cambridge Dr
Brevard, NC 28712-9111 - Phone
- (828) 424-0061
- NPI assigned
- May 9, 2016
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 390 | NC | Primary |
Addresses
Primary practice location
322 Cambridge Dr
Brevard, NC 28712-9111
Mailing address
322 Cambridge Dr
Brevard, NC 28712-9111
Phone (828) 424-0061
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200205002953 | NC | Practitioner - Occupational Therapist in Private Practice | 6709212947 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 390 | NC | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742860800000",
"number": "1255787248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "322 CAMBRIDGE DR",
"city": "BREVARD",
"state": "NC",
"postal_code": "287129111",
"telephone_number": "828-424-0061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "322 CAMBRIDGE DR",
"city": "BREVARD",
"state": "NC",
"postal_code": "287129111",
"telephone_number": "828-424-0061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "HUANNE",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-09",
"last_updated": "2025-03-25",
"certification_date": "2025-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brevard, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.