Douglene J Jackson, PHD, OTR/L, LMT, ATP

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT10451 Issued in FL

Practice address

240 NW 207TH Way
Pembroke Pines, FL 33029-3509

Phone

(678) 472-3201

NPI assigned

Apr 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• University of Miami

  • Hepatology Physician
  • Miami, FL
  • NPI 1013967827
  Medicare reassignment NPD
• University of Miami

  • Internal Medicine Physician
  • Miami Beach, FL
  • NPI 1124768627
  NPD
• University of Miami

  • Hearing and Speech Clinic/Center
  • Miami, FL
  • NPI 1467403998
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1275655482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 NW 207TH WAY",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330293509",
            "telephone_number": "678-472-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 NW 207TH WAY",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330293509",
            "telephone_number": "678-472-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DOUGLENE",
        "middle_name": "J",
        "credential": "PHD, OTR/L, LMT, ATP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA29727",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT003627",
            "primary": false
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT10451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J.M. Dental Group Inc
• J.R.Therapy Inc
• Sheba J Jackman, APRN
• Melissa Jackson-Pownall, LMHC
• Belliaminowa Viloria Jackson, MD
• John Edward Jackson, BS MS,LMHC,CAP
• Sandina Samantha Jackson, APRN
• Bindhu Jacob, APRN
• Jeffy Jacob, DO
• Ralph Jacob, COTA

• Occupational Therapist in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; 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.

Verify at the official NPI Registry.