Scott Aaron Jackson, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

10401 Issued in CA

Practice address

755 Fallen Leaf CT
Fairfield, CA 94534-4038

Phone

(707) 646-4150

NPI assigned

Jan 18, 2007

Sex

Male

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 CA

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northbay Physicians Surgery Center, LLCGroup PAC ID 0042122244, 336 clinicians

Northbay Health Medical FoundationGroup PAC ID 3274010871, 207 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Northbay Health Medical Foundation

  • Internal Medicine Physician
  • Fairfield, CA
  • NPI 1760283527
  Medicare reassignment Care Compare group NPD
• Northbay Healthcare Group

  • General Acute Care Hospital
  • Fairfield, CA
  • NPI 1821147786
  Medicare reassignment Care Compare group NPD
• Northbay Healthcare Group

  • Multi-Specialty Clinic/Center
  • Vacaville, CA
  • NPI 1760534713
  NPD
• Northbay Healthcare Group

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Fairfield, CA
  • NPI 1780736736
  NPD

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1356494934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 FALLEN LEAF CT",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945344038",
            "telephone_number": "707-864-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 FALLEN LEAF CT",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945344038",
            "telephone_number": "707-646-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SCOTT",
        "middle_name": "AARON",
        "name_prefix": "Mr.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "10401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fateen Lateef Jackson I
• Kyle Lamet Jackson
• Latasha Jackson
• Lisa Ann Jackson
• Naomi Jackson
• Tonya Annette Jackson, REGISTERED NURSE
• Zariah Jackson
• Sneha Susan Jacob
• Julyana Denae Jacobs
• Tiana Jacobs

• Speech-Language Pathologist in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.