Kristin Burch Jackson, PT, DPT, CMTPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

004956 Issued in KY

Practice address

317 Wallace Ave Ste 203
Louisville, KY 40207-3060

Phone

(502) 209-7677

NPI assigned

Oct 21, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.29 of 100Reported as apm

Quality

87.32

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Baptist Health Medical Group Inc

  dba Dawson Springs Rural Health Clinic

  • Rural Health Clinic/Center
  • Dawson Springs, KY
  • NPI 1982178216
  Medicare reassignment Care Compare group NPD
• Baptist Health Medical Group Inc

  • Urgent Care Clinic/Center
  • Louisville, KY
  • NPI 1508269200
  NPD
• Baptist Community Health Services Inc

  • Urgent Care Clinic/Center
  • Louisville, KY
  • NPI 1023275500
  NPD (past)
• Baptist Health Medical Group Inc

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1780961300
  NPD (past)

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1497398697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 KITTY HAWK WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402071753",
            "telephone_number": "859-619-2349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 WALLACE AVE STE 203",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073060",
            "telephone_number": "502-209-7677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6580 Kenwood Crossing Rd",
            "address_purpose": "LOCATION",
            "city": "Crestwood",
            "state": "KY",
            "postal_code": "400147614",
            "country_code": "US",
            "telephone_number": "502-241-1660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KRISTIN",
        "middle_name": "BURCH",
        "credential": "PT, DPT, CMTPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "KY",
            "license": "004956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "futurestatephysicaltherapy.com",
            "affiliation": "N",
            "endpointDescription": "business website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "317 Wallace Ave Ste 203",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402073060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjackson7343@bhkydirect.com",
            "affiliation": "N",
            "address_1": "6580 Kenwood Crossing Rd",
            "city": "Crestwood",
            "state": "KY",
            "country_code": "US",
            "postal_code": "400147614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joseph F. Jackson Jr., AGACNP-BC
• Kayla Brockwell Jackson, ARNP
• Kelly Elaine Jackson, MS, CGC
• Keyahna Jackson
• Kim E Jackson, LMFTA
• Kristyn Jackson, PH.D.
• Lewis Jackson, PHD
• Lindsay Jackson, PHARMD
• Lorie G Jackson, PTA
• Lydia Jackson

• Orthopedic Physical Therapist in Louisville, KY
• Providers in Louisville, KY by specialty
• Orthopedic Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.