Savannah Leigh Jackson, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

4161 Issued in SC

Practice address

222 Ladean CT Ste E
Simpsonville, SC 29680-7504

Phone

(864) 408-9509

NPI assigned

Mar 26, 2019

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

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Senior Rehab Source

  • Physical Therapist
  • Spartanburg, SC
  • NPI 1043464118
  Medicare reassignment NPD

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1700347515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 SPARTAN CT",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296503016",
            "telephone_number": "864-275-1457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 LADEAN CT STE E",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296807504",
            "telephone_number": "864-408-9509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SAVANNAH",
        "middle_name": "LEIGH",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "4161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manuel Eulysses Izquierdo, D.O.
• Adina Jackson
• Jaquinda Jackson
• Raymond Timothy Jackson, RPH
• Rebecca Elizabeth Jackson, DPT
• Sophia Jackson
• David C Jacobs, M.D.
• Jake Jacomet, DDS
• James F Richardson MD PA
• Joe E James

• Occupational Therapist in Simpsonville, SC
• Providers in Simpsonville, SC by specialty
• Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; 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.