Tabita Jackson

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

3500104616 Issued in MI

Practice address

11160 WJ Presley Pkwy Ste 102
Allendale, MI 49401-8075

Phone

(616) 384-2810

NPI assigned

Jan 3, 2007

Sex

Female

Sole proprietor

No

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

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.

• Michigan Ear, Nose, Throat, and Allergy Specialists, PC

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Holland, MI
  • NPI 1780029991
  NPD
• Sonus-USA, Inc.

  • Audiologist-Hearing Aid Fitter
  • Grand Rapids, MI
  • NPI 1053364190
  NPD (past)
• Sonus-USA, Inc.

  • Audiologist-Hearing Aid Fitter
  • Eugene, OR
  • NPI 1780765099
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1316004880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 RANDALL AVE NW",
            "city": "WALKER",
            "state": "MI",
            "postal_code": "495347541",
            "telephone_number": "616-633-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11160 WJ PRESLEY PKWY STE 102",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494018075",
            "telephone_number": "616-384-2810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 Fulton St E",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495033211",
            "country_code": "US",
            "telephone_number": "616-459-7122",
            "fax_number": "616-459-3277",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1425 Michigan St NE Ste A",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495032027",
            "country_code": "US",
            "telephone_number": "616-459-4514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TABITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "MI",
            "license": "3500104616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen James Hickner, MD
• Frederick Hoekzema Jr., DDS
• Ella Hudson
• Stacey Hysell
• Fluarry Dwayne Jackson Jr., LLMSW
• Donaira Jacobs
• Todd Jacob Jager I, ATC
• Trent Andrew Johnson, DC
• Komilakhon Karimova
• KB Chiropractic PLLC

• Hearing Instrument Specialist in Allendale, MI
• Providers in Allendale, MI by specialty
• Hearing Instrument Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.