Michelle A Jackson

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0005694 Issued in CO

Practice address

355 Kingbird Cir
Highlands Ranch, CO 80129-5698

Phone

(919) 606-6400

NPI assigned

Sep 21, 2011

Last updated

Aug 6, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Covell Care and Rehabilitation, LLC

  • Home Health Agency
  • Windsor, CO
  • NPI 1063695351
  Medicare reassignment NPD

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1699058008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 KINGBIRD CIR",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801295698",
            "telephone_number": "919-606-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 KINGBIRD CIR",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801295698",
            "telephone_number": "919-606-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6045 Ashford Ln",
            "address_2": "unit 102",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341102416",
            "country_code": "US",
            "telephone_number": "919-606-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MICHELLE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "0005694",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "14246",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO DEPT OF REGULATION",
            "identifier": "0005694",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Summer Renee Irelan, PA-C, MMS
• Ivy Comprehensive Care LLC
• Tatyana Izrailev, PHARMD
• J Co Physical Therapy (MVMT Loft)
• Lora A Jackson, NP
• Sephora Chantal Jacob, LMT
• Jodi Jacobs, LCSW
• Lawrence L Jacobs, O.D.
• Michael Grant Jacobs, D.D.S
• Cynthia Diane Jacobson, P.T.

• Occupational Therapist in Highlands Ranch, CO
• Providers in Highlands Ranch, CO by specialty
• Occupational Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.