Individual provider Active NPI

Erin Hosie Jackson, MSPT, CPI

  • Physical Therapist
  • Laguna Beach, CA
National Provider Identifier
1366555211
Registry record updated Dec 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20223 Issued in CA
Practice address
1100 S Coast Hwy
Suite 301 B
Laguna Beach, CA 92651-2968
Phone
(949) 494-3200
Fax
(949) 494-3222
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 20223 CA Primary

Addresses

Primary practice location

1100 S Coast Hwy
Suite 301 B
Laguna Beach, CA 92651-2968

Mailing address

11 Baneberry
Aliso Viejo, CA 92656-2147
Phone (949) 716-9616

Other identifiers 1

IdentifierTypeStateIssuer
DQ684AOtherCAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100625000660 CA Practitioner - Physical Therapist in Private Practice 7618922105 Practice locations: Laguna Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1100S Coast Hwy 301
Laguna Beach, CA 92651-2970
Phone (949) 307-7914

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20223CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Studio and Physical Therapy CurrentSince Oct 19, 2010 Accepting new patients
California Therapy Solutions Past Accepting new patients
California Therapy Solutions Physical Therapist Past Accepting new patients

Locations

1100 S Coast Hwy
Ste 301B
Laguna Beach, CA 92651
Phone (949) 376-2782

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292976000000",
    "number": "1366555211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 BANEBERRY",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926562147",
            "telephone_number": "949-716-9616",
            "fax_number": "949-494-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S COAST HWY",
            "address_2": "SUITE 301 B",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512968",
            "telephone_number": "949-494-3200",
            "fax_number": "949-494-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ERIN",
        "middle_name": "HOSIE",
        "credential": "MSPT, CPI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2010-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "20223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "DQ684A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; 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.