Jordan Alexa Jackson, PT, DPT, SCS

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

11-07296 Issued in KS

Practice address

1801 N 98TH St
Kansas City, KS 66111-1869

Phone

(913) 264-3000

Fax

(816) 302-9939

NPI assigned

Jun 1, 2023

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

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1700579968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-701-5200",
            "fax_number": "816-302-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N 98TH ST",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661111869",
            "telephone_number": "913-264-3000",
            "fax_number": "816-302-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JORDAN",
        "middle_name": "ALEXA",
        "credential": "PT, DPT, SCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-01",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "KS",
            "license": "11-07296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Javaneh Jabbari, MD
• Angela Jackson, CERTIF HAIR LOSS SPE
• Arianna Jackson, DDS
• Bradley Stevens Jackson, M.D.
• Derrick Jackson
• Kelsey Nicole Jackson, APRN-CNP
• Lateasha C Jackson
• Mollie J Jackson, DO
• Quinn Michelle Jackson, M.D.
• Randolph Thomas Jackson, M.D.

• Sports Physical Therapist in Kansas City, KS
• Providers in Kansas City, KS by specialty
• Sports Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.