Lauretta E Jackson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1069326 Issued in TX

Practice address

1121 E 7TH St
Austin, TX 78702-3220

Phone

(512) 334-4411

Fax

(512) 334-4465

NPI assigned

Sep 8, 2008

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

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.

• Any Baby Can of Austin, Inc.

  • Developmental Disabilities Clinic/Center
  • Austin, TX
  • NPI 1487783379
  NPD (past)

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220832000000",
    "number": "1336397884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 E 7TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787023220",
            "telephone_number": "512-334-4411",
            "fax_number": "512-334-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 E 7TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787023220",
            "telephone_number": "512-334-4411",
            "fax_number": "512-334-4465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LAURETTA",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-08",
        "last_updated": "2008-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1069326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kasey B Jackson, LCSW-S
• Katherine Anne Jackson, PNP
• Keri Michelle Jackson, P.T.
• Kimberly Jackson, LCSW
• Ladaun Jackson, M.A., CCC-SLP
• Lisa G Jackson, R.PH.
• Lynn C Jackson, P.T.
• Margerae R Jackson, LPC
• Maria D Jackson, LMFT, LPC
• Melanie Jackson, RN

• 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 Sep 8, 2008; 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.