Emma Jackson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

20643 Issued in MA

Practice address

22 Mill St
Suite 406
Arlington, MA 02476-4784

Phone

(781) 646-8440

Fax

(781) 643-7542

NPI assigned

Mar 26, 2015

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

Other identifiers 2

Other names 1

• Emma Mitchell-Rekrut Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1669866786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CREDIT UNION WAY",
            "address_2": "FL. 3",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684633",
            "telephone_number": "781-961-3370",
            "fax_number": "781-961-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MILL ST",
            "address_2": "SUITE 406",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024764784",
            "telephone_number": "781-646-8440",
            "fax_number": "781-643-7542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "EMMA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-26",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "20643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "S400274054",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110110967A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMMA",
            "last_name": "MITCHELL-REKRUT",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Caitlin A Isbister, LIC.AC., MSTOM
• Steven Joel Isenberg, ED.D.
• IV Solutions,Inc.
• Bridget Ivanyi, DC
• Sarah Jackel
• Mary H Jacobsen, MSW
• Michael Francis Jacques, PH.D.
• Sharon W Jacques, PH.D.
• Catherine A Jaffe, PMH. CNS-BC
• JBG, PC

• All providers in Arlington, MA
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; 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.