Active NPI
Dawn Jackson
- Massage Therapist
- Newark, DE
National Provider Identifier
1689916017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT-0003145
- Practice address
- 1 Centurian Dr
Suite 303
Newark, DE 19713-2137 - Phone
- (302) 373-3463
- NPI assigned
- Mar 24, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT-0003145 | DE | Primary |
Addresses
Primary practice location
1 Centurian Dr
Suite 303
Newark, DE 19713-2137
Mailing address
2207 Concord Pike # 207
Wilmington, DE 19803-2908
Phone (302) 373-3463
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT-0003145 | DE | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364083200000",
"number": "1689916017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2207 CONCORD PIKE # 207",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198032908",
"telephone_number": "302-373-3463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CENTURIAN DR",
"address_2": "SUITE 303",
"city": "NEWARK",
"state": "DE",
"postal_code": "197132137",
"telephone_number": "302-373-3463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "DAWN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-24",
"last_updated": "2013-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "DE",
"license": "MT-0003145",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.