Active NPI
Louise G. Jackson, ST.
- Speech-Language Pathologist
- Charleston, SC
National Provider Identifier
1487988721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 342
- Practice address
- 930 Folly Rd Ste B
Charleston, SC 29412-3938 - Phone
- (888) 510-6369
- Fax
- (888) 510-9156
- NPI assigned
- Sep 18, 2009
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 342 | SC | Primary |
Addresses
Primary practice location
930 Folly Rd Ste B
Charleston, SC 29412-3938
Mailing address
930 Folly Rd Ste B
Charleston, SC 29412-3938
Phone (888) 510-6369
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": "1253232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484265600000",
"number": "1487988721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "930 FOLLY RD STE B",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294123938",
"telephone_number": "888-510-6369",
"fax_number": "888-510-9156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "930 FOLLY RD STE B",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294123938",
"telephone_number": "888-510-6369",
"fax_number": "888-510-9156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "LOUISE",
"middle_name": "G.",
"name_prefix": "Ms.",
"credential": "ST.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-18",
"last_updated": "2017-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "SC",
"license": "342",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.