Dyneisha Akel Jackson

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

1366736 Issued in TX

Practice address

2300 Clear Creek Rd Ste 102
Killeen, TX 76549-4985

Phone

(254) 554-2637

NPI assigned

Apr 25, 2023

Last updated

Apr 25, 2023By 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

State licenses

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.

• River Region Rehab, LLC

  dba PT Solutions of Louisiana

  • Physical Therapist
  • Luling, LA
  • NPI 1407829252
  NPD
• Metroplex Adventist Hospital Inc

  dba AdventHealth Rollins Brook

  • Critical Access Hospital
  • Lampasas, TX
  • NPI 1255447181
  NPD (past)

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1629766936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 CLEAR CREEK RD STE 102",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765494985",
            "telephone_number": "254-554-2637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 CLEAR CREEK RD STE 102",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765494985",
            "telephone_number": "254-554-2637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DYNEISHA",
        "middle_name": "AKEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TX",
            "license": "1366736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Giovanni Rae Iturrino
• Liana Gennadyevna Izmalkova, DDS
• Jack Jones Hearing Centers, Inc. (AudioNova)
• Akeibia Rashae Jackson
• Autumn Jackson
• Marlee Jackson
• Melody Jackson
• Michael Jackson
• Rosyln Jackson
• Roxanna Jackson

• Orthopedic Physical Therapist in Killeen, TX
• Providers in Killeen, TX by specialty
• Orthopedic Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.