Earlene Jackson, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

23062 Issued in MD

Practice address

7404 Executive PL
#300B
Lanham, MD 20706-2268

Phone

(301) 599-9500

NPI assigned

Mar 27, 2012

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

Enrolled in DC, MD2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

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.

• LHMG Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Annapolis, MD
  • NPI 1396122842
  Medicare reassignment
• Maryland Luna Care Physical Therapy LLC

  • Physical Therapist
  • Chevy Chase, MD
  • NPI 1083340988

  DC

  Medicare reassignment
• Capital Orthopaedic Specialists LLC

  • Orthopaedic Surgery Physician
  • Suitland, MD
  • NPI 1821501735
  NPD (past)

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1417223256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7404 EXECUTIVE PL",
            "address_2": "#300B",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207062268",
            "telephone_number": "301-599-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7404 EXECUTIVE PL",
            "address_2": "#300B",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207062268",
            "telephone_number": "301-599-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "EARLENE",
        "name_prefix": "Ms.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-27",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J Rapha Clinic LLC
• Hendretta Jabatie
• Isabella Jabosung
• Stephine Raven Jackson-Elder
• Damaya E Jackson, BEHAVIOR TECHNICIAN
• Jacqueline Jackson
• Kaelyn Monet Jackson
• Laportia Shinese Jackson, LMSW
• London Monet Jackson
• Maurine D Jackson

• Physical Therapist in Lanham, MD
• Providers in Lanham, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.