Frank Kenneth Jackson, D.O.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

OP60742174 Issued in WA

Practice address

711 S Cowley St Ste 224
Spokane, WA 99202-1330

Phone

(509) 473-6706

Fax

(509) 473-6704

NPI assigned

Apr 24, 2013

Last updated

Nov 13, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Providence Health & Services Washington

  dba Providence Medical Group

  • Pulmonary Disease Physician
  • Spokane, WA
  • NPI 1194099390

  Physical Medicine & Rehabilitation

  Medicare reassignment NPD
• Providence Health & Services Washington

  dba PMG PHC Providence Express Care

  • General Practice Physician
  • Spokane, WA
  • NPI 1306391446
  NPD
• Neurology Associates of Spokane

  • Neurology Physician
  • Spokane, WA
  • NPI 1477690618
  NPD (past)
• Providence Health & Services - Washington

  dba Providence St. Peter Chemical Dependency Center

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Hoquiam, WA
  • NPI 1043374119
  NPD (past)
• Providence Health & Services- Washington

  dba Providence St Lukes Rehabilitation Medical Center

  • Rehabilitation Hospital
  • Spokane, WA
  • NPI 1497752091
  NPD (past)

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510531200000",
    "number": "1548604200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 469",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992100469",
            "telephone_number": "509-473-6706",
            "fax_number": "509-473-6704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 S COWLEY ST STE 224",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021330",
            "telephone_number": "509-473-6706",
            "fax_number": "509-473-6704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "FRANK",
        "middle_name": "KENNETH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-24",
        "last_updated": "2017-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "OP60742174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Elizabeth Jackson-Stiller
• Candy L Jackson, R.D.
• Casey Jackson, MSW, LICSW
• Chavis Jackson, D.O
• Erica Jackson
• Joshua K Jackson
• Kari Jackson
• Kaylee Marie Jackson
• Moneefah Jackson, LSW, LSWAIC
• Roberta A Jackson, CCC-SLP

• Physical Medicine & Rehabilitation Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Physical Medicine & Rehabilitation Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.