Azeb Jackson

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305203530 Issued in VA

Practice address

4900 High St W
Portsmouth, VA 23703-4226

Phone

(757) 354-6988

NPI assigned

Aug 28, 2024

Last updated

Aug 28, 2024By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Kempsville Wellness LLC

  • Physical Therapy Clinic/Center
  • Virginia Beach, VA
  • NPI 1619741139
  NPD
• Professional Chiropractic & Rehabilition Center P.C.

  • Chiropractor
  • Virginia Beach, VA
  • NPI 1023181302
  NPD

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1588498075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 DOGWOOD TRL",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237033806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 HIGH ST W",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237034226",
            "telephone_number": "757-354-6988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "AZEB",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305203530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isc Portsmouth Health Services Division Uscg
• Isc Portsmouth VA.
• J & S Loving and Caring Transportationllc
• Ronston Jackman, MD
• Lucretia Jackson-Kamm, PRACTICAL NURSE
• Dandria Jackson, PSY.D
• Isaiah William Jackson, MD
• Laura Ashlyn Broome Jackson, PHARMD
• Maggie Jackson, RDH (BSDH/MASTER OF
• Monica Maigol Jackson, MD

• Physical Therapist in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.