Gerald Michael Jackson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0624 Issued in NV

Practice address

2100 E Calvada Blvd
Pahrump, NV 89048-5805

Phone

(775) 727-7959

Fax

(775) 727-7960

NPI assigned

Feb 13, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mustard Seeds Therapies LLCGroup PAC ID 5395241160, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: advancedspineandposture.geraldjackson@142240.advancedmd-direct.com

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.

• Mustard Seeds Therapies LLC

  • Physical Therapist
  • Pahrump, NV
  • NPI 1255124475
  Medicare reassignment Care Compare group NPD
• Community Health Alliance

  • Pharmacy
  • Sun Valley, NV
  • NPI 1720728298
  NPD (past)
• Power Health Chiropractic Inc

  • Chiropractor
  • Reno, NV
  • NPI 1376698217
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1730221029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 E CALVADA BLVD",
            "city": "PAHRUMP",
            "state": "NV",
            "postal_code": "890485805",
            "telephone_number": "775-727-7959",
            "fax_number": "775-727-7960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 E CALVADA BLVD",
            "city": "PAHRUMP",
            "state": "NV",
            "postal_code": "890485805",
            "telephone_number": "775-727-7959",
            "fax_number": "775-727-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "GERALD",
        "middle_name": "MICHAEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "0624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730221029",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Integrity Taxi, LLC
• John Maxwell Isenhour-Burlake
• J H Daulat DO PC (Mohave Dermatology)
• Jackson Health and Theater
• Diane Jackson
• Ruby Angela Jametsky
• Melissa Jarman
• Jaws LTD
• JD Tom Ventures LLC
• Jebco Private Services

• Physical Therapist in Pahrump, NV
• Providers in Pahrump, NV by specialty
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.