Jessica Lynn Jackson, DPT, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-6424 Issued in ID

Practice address

1444 Falls Ave E
Twin Falls, ID 83301-3408

Phone

(208) 736-2574

Fax

(208) 736-2594

NPI assigned

May 15, 2019

Last updated

Sep 17, 2020By the provider in NPPES

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 names 1

• Jessica Lynn Glover Former name

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ihc Health Services Inc

  dba Intermountain Physical Therapy and Rehabilitation

  • Rehabilitation Clinic/Center
  • Salt Lake City, UT
  • NPI 1033822085

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1538725593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 FALLS AVE E STE 415",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1444 FALLS AVE E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013408",
            "telephone_number": "208-736-2574",
            "fax_number": "208-736-2594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-6424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "GLOVER",
            "middle_name": "LYNN",
            "credential": "DPT, PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joseph W Ippolito Jr., M.D.
• Chelsea Ann Irish
• Bernardo Isuani, MD
• Kristina Ivey, CCC-SLP
• Carrie A Jackman, PHARMD
• William A Jacobs, PA-C
• Kara Jacobsen, LSW
• Camilyn Jahn, CPM, LM
• James T Annest MD PC
• Jan Sund FNP,PC

• Physical Therapist in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.