Makayla Azaria Jackson

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1030 Loftis Blvd Ste 103
Newport News, VA 23606-2999

Phone

(757) 720-0099

NPI assigned

Jul 25, 2024

Last updated

Jul 25, 2024By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Autism Therapeutic Services

  dba HealthPRO Pediatrics

  • Behavior Analyst
  • Fayetteville, NC
  • NPI 1598067449

  Behavior Technician

  NPD (past)

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

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1356179832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 LOFTIS BLVD STE 103",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062999",
            "telephone_number": "757-720-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 LOFTIS BLVD STE 103",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062999",
            "telephone_number": "757-720-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MAKAYLA",
        "middle_name": "AZARIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cara Marie Jackson, D.O.
• Christian Jackson, SLP
• Edward Jackson
• Jason Jackson
• Lacey J Jackson, PHARMD
• Meria Eisenbraun Jackson, CRNA, MSN
• Michele Eloise Jackson, RESIDENT IN COUNSELI
• Shannon Jackson, PTA
• Nesreen Jacob
• Cassie Jacobs, LCSW

• Behavior Technician in Newport News, VA
• Providers in Newport News, VA by specialty
• Behavior Technician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.