Zipphrah F Jackson, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA002352 Issued in GA

Practice address

3100 Northside Pkwy NW
Atlanta, GA 30327-1563

Phone

(404) 480-6144

NPI assigned

Dec 19, 2017

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1649786252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4749 BROOKWOOD VW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303497062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 NORTHSIDE PKWY NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303271563",
            "telephone_number": "404-480-6144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ZIPPHRAH",
        "middle_name": "F",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-19",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "GA",
            "license": "OTA002352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy S Jackson, FNP-C
• Whitney Jackson
• William Thomas Jackson, M.S., ATC
• Wykena Jatawn Jackson, M.D.
• Yolanda Trenett Jackson, PTA
• Christine Mary Jacob, APRN
• Jesse Thomas Jacob, MD
• Lamanda Marie Jacob
• Maryann Kuruvilla Jacob, M.D.
• Aneisha B Jacobs, RN, WHNP-BC

• Occupational Therapy Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Occupational Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.