NPIMap

Individual provider Active NPI

David Nathan Jackson, PT

  • Physical Therapist
  • Tyler, TX
National Provider Identifier
1548456502
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1156269 Issued in TX
Practice address
7922 S Broadway Ave
Tyler, TX 75703-5242
Phone
(903) 983-7775
NPI assigned
Sep 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1156269 TX Primary

Addresses

Primary practice location

7922 S Broadway Ave
Tyler, TX 75703-5242

Mailing address

PO Box 6336
Tyler, TX 75711-6336
Phone (903) 388-8378

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hopestone Hospice & Palliative Care LLC PastSince Apr 1, 2020 Accepting new patients
Amerimed Home Equipment, LLC PastSince Mar 1, 2016 Accepting new patients
Choice Home Health Colorado, LLC PastSince Jul 1, 2024 Accepting new patients
Choice Home Health Arizona, LLC PastSince Oct 1, 2024 Accepting new patients
Pine Tree Home Health Care, LLC PastSince Jul 20, 2020 Accepting new patients
Comprehensive Hospice and Palliative Care, LLC PastSince Aug 1, 2022 Accepting new patients
A-Med Health LLC PastSince Dec 29, 2021 Accepting new patients
Hometown Quality Care, LLC PastSince Oct 23, 2024 Accepting new patients
CP Home Care, LLC PastSince Aug 10, 2018 Accepting new patients
Alliant Palliative Care and Hospice Co LLC PastSince Nov 12, 2025 Accepting new patients
Quality First Home Health Care, LLC PastSince Oct 23, 2024 Accepting new patients

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1190505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1548456502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6336",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757116336",
            "telephone_number": "903-388-8378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7922 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757035242",
            "telephone_number": "903-983-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DAVID",
        "middle_name": "NATHAN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-23",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1156269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; 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.