Keri Michelle Jackson, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1156681 Issued in TX

Practice address

4412 Reynosa Dr
Austin, TX 78739-4376

Phone

(512) 981-9574

NPI assigned

Oct 9, 2007

Last updated

Feb 4, 2025By the provider in NPPES

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

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Texas Luna Care Physical Therapy LLC

  • Physical Therapist
  • Southlake, TX
  • NPI 1790309656
  Medicare reassignment NPD
• Remedy Therapy Staffing - San Antonio PLLC

  • Home Health Agency
  • Austin, TX
  • NPI 1841812930
  NPD Authorized official
• Remedy Therapy Staffing PLLC

  • Home Health Agency
  • Austin, TX
  • NPI 1023630118
  NPD Authorized official
• Stellar Medical Staffing, LLC

  • Home Health Agency
  • Austin, TX
  • NPI 1972448702
  NPD Authorized official

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1316135049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4412 REYNOSA DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787394376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4412 REYNOSA DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787394376",
            "telephone_number": "512-981-9574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KERI",
        "middle_name": "MICHELLE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1156681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordyn Jackson
• Julie Jackson, LCSW
• Julie Elizabeth Jackson, M.D.
• Kasey B Jackson, LCSW-S
• Katherine Anne Jackson, PNP
• Kimberly Jackson, LCSW
• Ladaun Jackson, M.A., CCC-SLP
• Lauretta E Jackson, PT
• Lisa G Jackson, R.PH.
• Lynn C Jackson, P.T.

• Physical Therapist in Austin, TX
• Providers in Austin, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.