Shermeca Kyhana Jackson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6746 Issued in NC

Practice address

1903 S Hawthorne Rd
Dba Edwin H. Martinat Rehabilitation Center
Winston Salem, NC 27103-3916

Phone

(336) 718-6700

NPI assigned

Aug 31, 2006

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sjackson160029@direct.novanthealth.org

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.

• Foundation Health Systems LLC

  • Physical Therapy Clinic/Center
  • Winston Salem, NC
  • NPI 1205894029

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1669584124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 FRONTIS PLAZA BLVD STE 200",
            "address_2": "(ATTN) FORSYTH MEDICAL GROUP",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035616",
            "telephone_number": "336-277-2435",
            "fax_number": "336-277-9275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 S HAWTHORNE RD",
            "address_2": "DBA EDWIN H. MARTINAT REHABILITATION CENTER",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033916",
            "telephone_number": "336-718-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHERMECA",
        "middle_name": "KYHANA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "6746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SJACKSON160029@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "1903 S Hawthorne Rd",
            "address_2": "DBA Edwin H. Martinat Rehabilitation Center",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271033916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kerrington Jackson
• Linda L. Jackson, MAED., LPC, CGP, NCC
• Mary P Jackson, LCSWA
• Megan Ezelle Jackson, CRNA
• Richard Dewitt Jackson II, M.D.
• Staci Tate Jackson, SLP
• Teresa B. Jackson, RPH.
• Tommie S. Jackson
• Toni Beth Jackson, PA-C
• Travis Harold Jackson, MD

• Physical Therapist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.