Brianna L Jackson, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

23818 Issued in FL

Practice address

7010 15TH St N
Saint Petersburg, FL 33702-5738

Phone

(727) 200-4045

NPI assigned

Jun 13, 2019

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1568021475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13271 OPAL CT",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337731681",
            "telephone_number": "402-826-0414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7010 15TH ST N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337025738",
            "telephone_number": "727-200-4045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRIANNA",
        "middle_name": "L",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "23818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118446200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynn Stephanie Jackson Dorman, LMHC
• Greta Jackson-Mitchell
• Kashika Kenwella Jackson-Pride, DOULA
• Aemelia L Jackson
• Amanda Faith Jackson, OTR/L
• Caitlin Jackson, RN
• Christopher Jackson Jr.
• Christopher L Jackson, PHD, DOM, AP
• Debra E Jackson, ARNP
• Deja Jackson

• Occupational Therapist in Saint Petersburg, FL
• Providers in Saint Petersburg, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.