Jessica Jackson, MS, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

WV #709 Issued in WV

Practice address

179 Station Place Way
Suite 100
Hurricane, WV 25526-8747

Phone

(304) 760-6300

Fax

(304) 201-5123

NPI assigned

Aug 19, 2011

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

Credentials

Master of Science

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.

• Milestones Physical Therapy, Inc.

  • Physical Therapist
  • Hurricane, WV
  • NPI 1003950163
  NPD (past)

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313712000000",
    "number": "1376823559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 450",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255600450",
            "telephone_number": "304-760-6300",
            "fax_number": "304-201-5123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 STATION PLACE WAY",
            "address_2": "SUITE 100",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255268747",
            "telephone_number": "304-760-6300",
            "fax_number": "304-201-5123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JESSICA",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2011-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WV",
            "license": "WV #709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrated Health Care Providers, Inc.
• Integrated Health Care Providers, Inc.
• International Rehabilitative Sciences Inc.
• Karen Lynn Isner
• Alex Jackson
• Sarah Marie Jackson, MOT, OTR/L
• James W. Herman, OD
• Jonathan D. James, LPT
• Kathy Hickman James, CRNA
• Jane a. Kurucz, M.D., Inc

• Registered Dietitian in Hurricane, WV
• Providers in Hurricane, WV by specialty
• Registered Dietitian in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; 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.