Active NPI
Ronald B Jackson, PT
- Physical Therapist
- Edinburg, TX
National Provider Identifier
1285864520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1189147
- Practice address
- 116 Dawson St
Edinburg, TX 78539 - Phone
- (956) 287-7912
- Fax
- (956) 381-8015
- NPI assigned
- Jul 21, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1189147 | TX | Primary |
Addresses
Primary practice location
116 Dawson St
Edinburg, TX 78539
Mailing address
116 Dawson
Edinburg, TX 78539
Phone (956) 287-7912
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Victory Rehab LLC | Physical Therapist | 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.
-
- Physical Therapist
- Alamo, TX
- NPI 1831444801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660867200000",
"number": "1285864520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 DAWSON",
"city": "EDINBURG",
"state": "TX",
"postal_code": "78539",
"telephone_number": "956-287-7912",
"fax_number": "956-381-8015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 DAWSON ST",
"city": "EDINBURG",
"state": "TX",
"postal_code": "78539",
"telephone_number": "956-287-7912",
"fax_number": "956-381-8015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "RONALD",
"middle_name": "B",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-21",
"last_updated": "2022-08-19",
"certification_date": "2022-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1189147",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edinburg, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.