Active NPI
Amy Z Jackson, AU.D.
- Audiologist
- Conroe, TX
National Provider Identifier
1760146708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 51377
- Practice address
- 27310 Oak Ridge School Rd
Conroe, TX 77385-9042 - Phone
- (936) 709-8204
- Fax
- (936) 709-7557
- NPI assigned
- Oct 26, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 51377 | TX | Primary |
Addresses
Primary practice location
27310 Oak Ridge School Rd
Conroe, TX 77385-9042
Mailing address
27310 Oak Ridge School Rd
Conroe, TX 77385-9042
Phone (936) 709-8204
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 |
|---|---|---|---|
| 51377 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635206400000",
"number": "1760146708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27310 OAK RIDGE SCHOOL RD",
"city": "CONROE",
"state": "TX",
"postal_code": "773859042",
"telephone_number": "936-709-8204",
"fax_number": "936-709-7557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27310 OAK RIDGE SCHOOL RD",
"city": "CONROE",
"state": "TX",
"postal_code": "773859042",
"telephone_number": "936-709-8204",
"fax_number": "936-709-7557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "AMY",
"middle_name": "Z",
"name_prefix": "Dr.",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-26",
"last_updated": "2021-10-26",
"certification_date": "2021-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "TX",
"license": "51377",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conroe, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.