Organization Active NPI

Nathan Jackson PLLC

  • Physical Therapist
  • Tyler, TX
National Provider Identifier
1477797033
Registry record updated Aug 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
NATHAN JACKSON PLLC
Practice address
7922 S Broadway Ave
Tyler, TX 75703-5242
Phone
(903) 388-8378
NPI assigned
Apr 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2012

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

Authorized official

Name
David Nathan Jackson, P.T.
Title
President
Phone
(903) 388-8378

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X TX Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

7922 S Broadway Ave
Tyler, TX 75703-5242

Mailing address

PO Box 6336
Tyler, TX 75711-6336
Phone (903) 509-3773

Other names 1

  • Choice Rehab Doing business as

National Provider Directory

National Provider Directory

Locations

214 W Houston St
Ste B
Tyler, TX 75702
Phone (903) 388-8378

7922 S Broadway Ave
Tyler, TX 75703
Phone (903) 245-6695

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344384000000",
    "number": "1477797033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6336",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757116336",
            "telephone_number": "903-509-3773",
            "fax_number": "903-509-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7922 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757035242",
            "telephone_number": "903-388-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATHAN JACKSON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-27",
        "last_updated": "2012-08-08",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "NATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-388-8378",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Choice Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; 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.