Active NPI
Alicia Jackson Juckett, LPT
- Physical Therapist
- Cordova, TN
National Provider Identifier
1841295359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6841
- Practice address
- 8110 Cordova Rd
Ste 107
Cordova, TN 38016-0520 - Phone
- (901) 756-1650
- Fax
- (901) 756-1396
- NPI assigned
- Jun 21, 2005
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6841 | TN | Primary |
Addresses
Primary practice location
8110 Cordova Rd
Ste 107
Cordova, TN 38016-0520
Mailing address
8110 Cordova Road
Ste 107
Cordova, TN 38016-0517
Phone (901) 756-1650
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 |
|---|---|---|---|
| 6841 | TN | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221523200000",
"number": "1841295359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8110 CORDOVA ROAD",
"address_2": "STE 107",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380160517",
"telephone_number": "901-756-1650",
"fax_number": "901-756-1396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8110 CORDOVA RD",
"address_2": "STE 107",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380160520",
"telephone_number": "901-756-1650",
"fax_number": "901-756-1396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUCKETT",
"first_name": "ALICIA",
"middle_name": "JACKSON",
"name_prefix": "Mrs.",
"credential": "LPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-21",
"last_updated": "2008-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "6841",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cordova, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.