Belle Jackson

Primary specialty

MechanotherapistTaxonomy code 172M00000X

Practice address

2815 W Silver Lake Rd
Fenton, MI 48430-2655

Phone

(810) 629-4575

NPI assigned

Mar 24, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Belle Jackson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Hands-on Healing

  • Massage Therapist
  • Holly, MI
  • NPI 1053708453
  NPD (past) Authorized official

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300924800000",
    "number": "1679872014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8390 TIPSICO TRL",
            "city": "HOLLY",
            "state": "MI",
            "postal_code": "484428108",
            "telephone_number": "810-629-4575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 W SILVER LAKE RD",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302655",
            "telephone_number": "810-629-4575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-24",
        "last_updated": "2011-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BELLE",
            "last_name": "JACKSON",
            "credential": "NCTM",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Mechanotherapist in Fenton, MI
• Providers in Fenton, MI by specialty
• Mechanotherapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; 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.