Individual provider Active NPI

Allison Elizabeth Jackson

  • Occupational Therapy Assistant
  • Grand Ledge, MI
National Provider Identifier
1497475453
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5202008683 Issued in MI
Practice address
115 Ferguson St
Grand Ledge, MI 48837-1611
Phone
(989) 277-3156
NPI assigned
Aug 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5202008683 MI Primary

Addresses

Primary practice location

115 Ferguson St
Grand Ledge, MI 48837-1611

Mailing address

115 Ferguson St
Grand Ledge, MI 48837-1611
Phone (989) 277-3156

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

State licenses

LicenseStateTypeSpecialty
5202008683MIMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1497475453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 FERGUSON ST",
            "city": "GRAND LEDGE",
            "state": "MI",
            "postal_code": "488371611",
            "telephone_number": "989-277-3156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 FERGUSON ST",
            "city": "GRAND LEDGE",
            "state": "MI",
            "postal_code": "488371611",
            "telephone_number": "989-277-3156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ALLISON",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MI",
            "license": "5202008683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Ledge, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.

Verify at the official NPI Registry.