Active NPI
Regina Jackson
- Massage Therapist
- Mobile, AL
National Provider Identifier
1700651809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 3422
- Practice address
- 6920 Airport Blvd Ste 111
Mobile, AL 36608-3783 - Phone
- (251) 607-8531
- NPI assigned
- Nov 17, 2023
- Last updated
- Nov 17, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | 3422 | AL | Primary |
Addresses
Primary practice location
6920 Airport Blvd Ste 111
Mobile, AL 36608-3783
Mailing address
5714 Ramada Dr S
Mobile, AL 36693-3528
Phone (251) 680-6230
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 |
|---|---|---|---|
| 3422 | AL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700179200000",
"number": "1700651809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5714 RAMADA DR S",
"city": "MOBILE",
"state": "AL",
"postal_code": "366933528",
"telephone_number": "251-680-6230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6920 AIRPORT BLVD STE 111",
"city": "MOBILE",
"state": "AL",
"postal_code": "366083783",
"telephone_number": "251-607-8531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "REGINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-11-17",
"last_updated": "2023-11-17",
"certification_date": "2023-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "AL",
"license": "3422",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.