Renee Jackson, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT103060 Issued in TX

Practice address

9403 Rutherglen Dr
Dallas, TX 75227-4764

Phone

(214) 738-4668

NPI assigned

Nov 24, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1511481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1275047524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9403 RUTHERGLEN DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752274764",
            "telephone_number": "214-738-4668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9403 RUTHERGLEN DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752274764",
            "telephone_number": "214-738-4668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8117 Preston Rd Ste 160",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752256399",
            "country_code": "US",
            "telephone_number": "214-738-4668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT103060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nyeem Waleek Jackson
• Ora D Jackson, LPC-ASSOCIATE
• Parul Jackson, RPH
• Peggy Sue Jackson, FNP
• Penny Jackson
• Richard H Jackson, M.D.
• Rochelle Jackson, FNP-C
• Rod Dewey Jackson
• Ross Jackson, DDS
• Sarah Jackson, OT

• Massage Therapist in Dallas, TX
• Providers in Dallas, TX by specialty
• Massage Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.