Shawn Nichole Jackson, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

Practice address

1415 Route 70 E
Suite 103
Cherry Hill, NJ 08034-2210

Phone

(800) 670-3893

Fax

(856) 482-8498

NPI assigned

Oct 31, 2007

Sex

Female

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)

Not enrolled

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1841479342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9252 ASHLAND WOODS LN",
            "address_2": "APT A2",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220791805",
            "telephone_number": "703-339-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 ROUTE 70 E",
            "address_2": "SUITE 103",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342210",
            "telephone_number": "800-670-3893",
            "fax_number": "856-482-8498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHAWN",
        "middle_name": "NICHOLE",
        "name_prefix": "Miss",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Britany Jackson
• Donna Lynne Jackson, OT
• Keshawn M Jackson
• Khamill Jackson
• Mark R Jackson, OT
• Terrance Jackson, CRNA
• Tyshall Shamick Jackson, RN
• Sondra Nadeen Jacob, OTR
• Jessica Delores Jacobi
• Wendy June Jacobi, CRNP

• Occupational Therapy Assistant in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Occupational Therapy Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.