Toni M. Jackson, NCTMB

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

2005015267 Issued in MO

Practice address

4806 State St
Home Office
East Saint Louis, IL 62205-1355

Phone

(618) 225-2777

NPI assigned

Dec 7, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1376871103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4806 STATE ST",
            "address_2": "HOME OFFICE",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622051355",
            "telephone_number": "618-271-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4806 STATE ST",
            "address_2": "HOME OFFICE",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622051355",
            "telephone_number": "618-225-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TONI",
        "middle_name": "M.",
        "credential": "NCTMB",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-07",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "226000000X",
            "taxonomy_group": "",
            "desc": "Recreational Therapist Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "226300000X",
            "taxonomy_group": "",
            "desc": "Kinesiotherapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MO",
            "license": "2005015267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelica Howard
• Hoyleton Youth and Family Services
• Illinois Express Home Care
• Inspired Incorporated
• Howard Franklin Jackson, DPM
• Natascha R Jeffries, FNP, PMHNP
• April Jenkins
• Alfred Johnson, MD
• Christopher Vaughan Johnson, MD
• Sreekanth Kanagarla, D.D.S.

• Massage Therapist in East Saint Louis, IL
• Providers in East Saint Louis, IL by specialty
• Massage Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.