Active NPI
Chasity Jackson, DPT
- Physical Therapist
- Shreveport, LA
National Provider Identifier
1467072041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 09698R
- Practice address
- 1535 River Parkway Blvd Apt 208
Shreveport, LA 71104-1803 - Phone
- (870) 665-9462
- NPI assigned
- Apr 23, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 09698R | LA | Primary |
Addresses
Primary practice location
1535 River Parkway Blvd Apt 208
Shreveport, LA 71104-1803
Mailing address
245 Peregrine Way
Bossier City, LA 71112-2556
Phone (870) 665-9462
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667260800000",
"number": "1467072041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 PEREGRINE WAY",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711122556",
"telephone_number": "870-665-9462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1535 RIVER PARKWAY BLVD APT 208",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711041803",
"telephone_number": "870-665-9462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CHASITY",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-23",
"last_updated": "2022-11-01",
"certification_date": "2022-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "09698R",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.