Jonathan Mark Jackson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

60682 Issued in OR

Practice address

1000 3Rd St
Tillamook, OR 97141-3430

Phone

(503) 842-4444

NPI assigned

Nov 5, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Walker Physical Therapy, Inc

  • Physical Therapist
  • Sun City, CA
  • NPI 1154411650
  NPD (past)

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

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410307200000",
    "number": "1295062792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 3RD ST",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971413430",
            "telephone_number": "503-842-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 3RD ST",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971413430",
            "telephone_number": "503-842-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JONATHAN",
        "middle_name": "MARK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-05",
        "last_updated": "2014-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT35976",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-2974",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James C Hunter, RPH
• Danielle Leanne Hurd, LMT
• Sandra Lee Hurliman
• Nancy Michelle Inforzato, M.D.
• Anna Elizabeth Jackson, LMT
• Rodney Gilkey Jackson, DC
• Brandy Jacob
• Cyrus Berger Javadi, D.D.S
• Christopher Don Jenck, OD
• Shelby Lynn Jenck, APRN, FNP-BC

• Physical Therapist in Tillamook, OR
• Providers in Tillamook, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; 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.