Carrie Jacka

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

1465 Oakfield Dr
Brandon, FL 33511-4854

Phone

(509) 847-8847

NPI assigned

Aug 3, 2022

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

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Legacy Healthcare Services, Inc

  • Physical Therapist
  • Tampa, FL
  • NPI 1336535988

  Speech-Language Pathologist

  Medicare reassignment NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1356078075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9513 DELANEY CREEK BLVD APT 201",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336195181",
            "telephone_number": "509-847-8847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114854",
            "telephone_number": "509-847-8847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKA",
        "first_name": "CARRIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iwell Health and Wellness Clinic
• Priyanka Iyer, DDS
• Yudisnay Izquierdo Fiallo
• J Ting MD Inc
• J. Paonessa M.D. P.a.
• Ebene Jackson, RBT
• Julie Jackson, LCSW
• Manami Jackson
• Martie Marie Jackson, ARNP
• Rhonda S Jackson, ARNP

• Speech-Language Pathologist in Brandon, FL
• Providers in Brandon, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.