Active NPI
Eric Jackson, ATC
- Athletic Trainer
- Birmingham, AL
National Provider Identifier
1447728910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2170
- Practice address
- 1219 6TH Ave S
Birmingham, AL 35233 - Phone
- (205) 975-9256
- NPI assigned
- Nov 2, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2170 | AL | Primary |
Addresses
Primary practice location
1219 6TH Ave S
Birmingham, AL 35233
Mailing address
607 Oaks Dr
Birmingham, AL 35209-6985
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2170 | AL | MD | Group Psychotherapy Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541116800000",
"number": "1447728910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "607 OAKS DR",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352096985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1219 6TH AVE S",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "35233",
"telephone_number": "205-975-9256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "ERIC",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-02",
"last_updated": "2018-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AL",
"license": "2170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.