Katherine Marie Jackson, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

01108932 Issued in CO

Practice address

6595 S Dayton St
Suite 1500
Greenwood Village, CO 80111-6128

Phone

(303) 504-9945

Fax

(303) 504-9946

NPI assigned

Mar 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Master of Science

State licenses

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518085331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1734 W CRESTLINE AVE",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801201219",
            "telephone_number": "303-794-2201",
            "fax_number": "303-504-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6595 S DAYTON ST",
            "address_2": "SUITE 1500",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801116128",
            "telephone_number": "303-504-9945",
            "fax_number": "303-504-9946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KATHERINE",
        "middle_name": "MARIE",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "01108932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35653264",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "649046",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ivan S Naiman, DDS, PC
• Kimberly L Izer, MD
• Anthony Izzo, PTA
• J Scott Bainbridge MD PC
• Julie Elizabeth Jaakola, AG-ACNP-BC
• Katherine Nicole Jackson
• Malik Ar Jackson, DDS
• Joshua Jackstien, DMD
• Blu Jacobs
• Whitney James

• Speech-Language Pathologist in Greenwood Village, CO
• Providers in Greenwood Village, CO by specialty
• Speech-Language Pathologist in Colorado

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