Cara Jackson

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

TSLP-2578 Issued in ID

Practice address

1906 Fairview Ave Ste 330
Caldwell, ID 83605-5425

Phone

(208) 385-3680

NPI assigned

Jun 19, 2014

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

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  NPD (past)
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1295149094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7894 S DESERT RIDGE AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837165825",
            "telephone_number": "406-531-1397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 FAIRVIEW AVE STE 330",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836055425",
            "telephone_number": "208-385-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "TSLP-2578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Intermountain Physical Therapy Limited Partnership
• Edgardo Jose Irizarry, DC
• Brandon G Isaacs, DO
• Amber Marie Jackson, LCPC
• Ashlee Jackson, RN
• Holli Cheree Jackson, ATC, LMT, CES, PES
• Lyndell Jackson, LCPC
• Jae'S Transportaion LLC
• Randy L James, M.D.
• Craig R Jamison, PAC

• Speech-Language Pathologist in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Speech-Language Pathologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.