William Bradley Jackson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

8151 Issued in MA

Practice address

176 Division St
Great Barrington, MA 01230-1179

Phone

(413) 528-4289

NPI assigned

Aug 14, 2007

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187049600000",
    "number": "1487846366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 DIVISION ST",
            "city": "GREAT BARRINGTON",
            "state": "MA",
            "postal_code": "012301179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 DIVISION ST",
            "city": "GREAT BARRINGTON",
            "state": "MA",
            "postal_code": "012301179",
            "telephone_number": "413-528-4289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "WILLIAM",
        "middle_name": "BRADLEY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-14",
        "last_updated": "2007-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "8151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan Inglis, MD
• Innovative Therapy Solutions
• Invivo Institute Research Foundation Inc.
• Linda J Jackson, LIC. AC.
• Sarah Jackson, MFA, MA, LP
• Donna Withee Jacobs, LICSW
• Jay B Kain Physical Therapy
• Amy Jenter
• Gregory W Johns, RPH
• Jonathan Nacht DMD PC

• Physical Therapy Assistant in Great Barrington, MA
• Providers in Great Barrington, MA by specialty
• Physical Therapy Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; 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.