Beverly Jackson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA004284 Issued in GA

Practice address

665 Gaines School Rd
Athens, GA 30605-3127

Phone

(706) 369-8115

Fax

(706) 369-8116

NPI assigned

Mar 11, 2026

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• East Athens Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Athens, GA
  • NPI 1326082611
  NPD (past)

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

{
    "created_epoch": "1773187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1689521585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 GAINES SCHOOL RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306053127",
            "telephone_number": "706-369-8115",
            "fax_number": "706-369-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 GAINES SCHOOL RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306053127",
            "telephone_number": "706-369-8115",
            "fax_number": "706-369-8116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Tim Trl",
            "address_purpose": "LOCATION",
            "city": "Danielsville",
            "state": "GA",
            "postal_code": "306336929",
            "country_code": "US",
            "telephone_number": "706-795-0155",
            "fax_number": "706-795-0156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BEVERLY",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-11",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA004284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J Michael West MD PC
• J. Edward Dempsey, M.D., P.C.
• Sallay Jabbie
• Lori Jacks, LCSW
• Jackson Speech Therapy Services
• Cliff Jackson
• Elizabeth Jackson
• Hannah Jackson, LCSW
• Helen Jackson, MAT, MCD, CCC-SLP
• Larissa Jackson, MS

• Physical Therapy Assistant in Athens, GA
• Providers in Athens, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; 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.