Active NPI
Javier Jackson
- Physical Therapist
- Memphis, TN
National Provider Identifier
1801380985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT0000010916
- Practice address
- 2781 Airways Blvd
Memphis, TN 38132-1104 - Phone
- (901) 291-1100
- NPI assigned
- Jun 21, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT0000010916 | TN | Primary |
Addresses
Primary practice location
2781 Airways Blvd
Memphis, TN 38132-1104
Mailing address
3421 Cloudland Dr
Memphis, TN 38118-8125
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT0000010916 | TN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cross Creek Physical Therapy Limited Partnership | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapy Clinic/Center
- Olive Branch, MS
- NPI 1821030198
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529539200000",
"number": "1801380985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3421 CLOUDLAND DR",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381188125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2781 AIRWAYS BLVD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381321104",
"telephone_number": "901-291-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JAVIER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-21",
"last_updated": "2018-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "PT0000010916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.