Mary Christine Jackson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P16341 Issued in NC

Practice address

3000 Erwin Rd
Durham, NC 27705

Phone

(919) 684-2733

Fax

(919) 681-7574

NPI assigned

Jun 6, 2016

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

Enrolled in NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

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.

• Activcare Physical Therapy, LLC

  dba Pivot Physical Therapy of Carolina

  • Clinic/Center
  • Raleigh, NC
  • NPI 1548409626

  Physical Therapist

  Medicare reassignment NPD
• Duke University Health System, Inc.

  dba Duke University Hospital

  • Certified Registered Nurse Anesthetist
  • Durham, NC
  • NPI 1558392977

  Physical Therapist

  Medicare reassignment NPD
• Duke University Health System, Inc.

  dba Duke Home Infusion

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Durham, NC
  • NPI 1427187525
  NPD

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1396194833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 ERWIN RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054504",
            "telephone_number": "919-684-2733",
            "fax_number": "919-681-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 ERWIN RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27705",
            "telephone_number": "919-684-2733",
            "fax_number": "919-681-7574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 NCHwy 55",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "cary",
            "state": "NC",
            "postal_code": "27519",
            "country_code": "US",
            "telephone_number": "919-290-2799",
            "fax_number": "919-290-2532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MARY",
        "middle_name": "CHRISTINE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P16341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin P. Jackson, MD
• Larry Ronald Jackson II, M.D.
• Laura Jackson, LPT
• Lindsey A Jackson, FNP
• Lusayo Jackson
• Maya Jackson
• Rachael N.S Jackson
• Shannon Laura Jackson, RN
• Sharhonda Jackson, RN
• Sheena S Jackson, RD

• Physical Therapist in Durham, NC
• Providers in Durham, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.