Thomas Eugene Jackson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

9248 Issued in CA

Practice address

830 S. Citrus Ave
Suite 203
Azusa, CA 91702

Phone

(626) 339-6514

NPI assigned

Aug 28, 2007

Last updated

Aug 30, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Pacific Rehabilitation Services, Inc

  • Physical Therapist
  • Lancaster, CA
  • NPI 1447205828
  NPD (past)

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188432000000",
    "number": "1790979292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 MOUNTAIN VIEW AVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303607",
            "telephone_number": "323-255-9263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S. CITRUS AVE",
            "address_2": "SUITE 203",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "91702",
            "telephone_number": "626-339-6514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "THOMAS",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "9248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Hyman
• Aimee Christine Ibarra
• Independent Phlebotomy Services
• Brianna Isarraraz, HIGH SCHOOL DIPLOMA
• Armando J Islas, D.D.S.
• Nicole Jaffke
• James D. Ahn, DDS, Inc.
• Jean Kattar DDS Corp (Jean Kattar DDS)
• Joshua Jeleniowski, NP STUDEBT
• Susan Renee Jester

• Physical Therapist in Azusa, CA
• Providers in Azusa, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; 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.