Active NPI
Anastasia Jackson, MCD, CCC-SLP
- Speech-Language Pathologist
- Jonesboro, AR
National Provider Identifier
1770750952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP#1533
- Practice address
- 2506 Southwest SQ
Jonesboro, AR 72401-5982 - Phone
- (870) 933-5800
- NPI assigned
- May 15, 2008
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP#1533 | AR | Primary |
Addresses
Primary practice location
2506 Southwest SQ
Jonesboro, AR 72401-5982
Mailing address
2516 Rosewood Cir
Jonesboro, AR 72401-5936
Phone (870) 935-2223
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 |
|---|---|---|---|
| SP#1533 | AR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210896000000",
"number": "1770750952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2516 ROSEWOOD CIR",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724015936",
"telephone_number": "870-935-2223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2506 SOUTHWEST SQ",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724015982",
"telephone_number": "870-933-5800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "ANASTASIA",
"credential": "MCD, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-15",
"last_updated": "2008-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "SP#1533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jonesboro, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.