Nakea Jackson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

130311 Issued in AK

Practice address

398 Hamilton Ave
Fairbanks, AK 99701-3537

Phone

(907) 374-4911

NPI assigned

Feb 26, 2018

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519603200000",
    "number": "1619478682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 JASICA CT",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435125800",
            "telephone_number": "419-789-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "398 HAMILTON AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013537",
            "telephone_number": "907-374-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "NAKEA",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-26",
        "last_updated": "2018-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA011672",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AK",
            "license": "130311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Precious Eyewumi Izeagi, MSN, APRN, PMHNP-BC
• Jace LLC
• Amani Ayisha Jackson
• Cassie Thacker Jackson, MASTER OF EDUCATION
• Megan Jackson, FNP-C
• Rickale K Jackson
• Tanya L Jackson
• Vanessa Rachel Jackson, CDM
• Elizabeth D Jacobs, MA CCCSLP
• Jennifer Jacobs, MD, MPH

• Physical Therapy Assistant in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Physical Therapy Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; 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.