Gina Marie Jackson

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

102683 Issued in TX

Practice address

12371 S Kirkwood Rd
Stafford, TX 77477-2836

Phone

(713) 995-9292

Fax

(713) 995-4402

NPI assigned

Aug 10, 2009

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 and National Provider Directory roles.

• Health Rite Medical and Rehab Clinic, Inc.

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1093828865
  NPD
• Resource Therapy Center, LLC

  • Speech-Language Pathologist
  • Houston, TX
  • NPI 1023340957
  NPD
• Oakbend Medical Center

  • Skilled Nursing Facility
  • Katy, TX
  • NPI 1558137075
  NPD (past)

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1639301682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12400 SHADOW CREEK PKWY",
            "address_2": "APT 2406",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847360",
            "telephone_number": "713-995-9292",
            "fax_number": "713-995-4402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12371 S KIRKWOOD RD",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774772836",
            "telephone_number": "713-995-9292",
            "fax_number": "713-995-4402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-10",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "102683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• It'S Heaven, LLC
• Georgina Ita
• Ivy Health Care Supply
• Amanda Christine Jackey
• Ella Mae Jackson
• Linda Johnson Jackson, PH.D.
• Myshonique M Jackson, LVN
• Brittany Jager
• Sahar Jamalyaria, DO
• Judithe Janvier

• Pediatric Occupational Therapist in Stafford, TX
• Providers in Stafford, TX by specialty
• Pediatric Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.