Craig Jackson, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

981 Issued in SC

Practice address

2423 Castlereagh Rd
Charleston, SC 29414-6134

Phone

(843) 819-9470

Fax

(877) 286-5727

NPI assigned

Jul 31, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217462400000",
    "number": "1659537512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 CASTLEREAGH RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294146134",
            "telephone_number": "843-819-9470",
            "fax_number": "877-286-5727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 CASTLEREAGH RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294146134",
            "telephone_number": "843-819-9470",
            "fax_number": "877-286-5727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CRAIG",
        "name_prefix": "Mr.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-31",
        "last_updated": "2008-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY, INC",
            "identifier": "979693",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF SC DEPT OF LABOR, LICENSING AND REGULATION BOARD OF OT EXAMINERS",
            "identifier": "981",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aisha Abeo Jackson, M.D.
• Amy Jackson, MA
• Bakari Jackson
• Benjamin F Jackson, MD
• Chloe Jackson
• Desralei Jackson, LCSW,ACSW
• Francesca Maliya Jackson, LISW-CP
• Gregory Ryan Jackson, M.D.
• Jennifer Jackson, MA, LPCS
• Julia Jackson

• Occupational Therapy Assistant in Charleston, SC
• Providers in Charleston, SC by specialty
• Occupational Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.