Jackson Beauregard Burns

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

16818 Wrangler Rd
Rosharon, TX 77583-7327

Phone

(432) 251-8598

NPI assigned

Oct 3, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1295515518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16818 WRANGLER RD",
            "city": "ROSHARON",
            "state": "TX",
            "postal_code": "775837327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16818 WRANGLER RD",
            "city": "ROSHARON",
            "state": "TX",
            "postal_code": "775837327",
            "telephone_number": "432-251-8598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "JACKSON",
        "middle_name": "BEAUREGARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronnie Broussard
• Shanna Lashawn Broussard, CRC
• Lawanda Brown
• Franchesca D Bryant, M.ED
• Danielle Buckholt, MS, ATC
• Engelbert Cambri, PHARMD
• Care Physician of Rosharon PLLC
• Caring Hands Home Care Agency LLC
• Simone E Chambers, RPH
• Chancewell Behavioral Health LLC

• All providers in Rosharon, TX
• Student in an Organized Health Care Education/Training Program in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.