NPIMap

Organization Active NPI

Lynn Jackson, PT, PC

  • Physical Therapist
  • Austin, TX
National Provider Identifier
1871779256
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1113850 Issued in TX
Legal business name
LYNN JACKSON, PT, PC
Practice address
6012 W William Cannon Dr
BLDG C-101
Austin, TX 78749-1980
Phone
(512) 899-8508
Fax
(512) 899-9387
NPI assigned
Jan 15, 2008
Last updated
Jan 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lynn Jackson, PT ,PCNPI 1689779522
Title
Owner
Phone
(512) 899-8508

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1113850 TX Primary

Addresses

Primary practice location

6012 W William Cannon Dr
BLDG C-101
Austin, TX 78749-1980

Mailing address

PO Box 91419
Austin, TX 78709-1419
Phone (512) 899-8508

Other identifiers 1

IdentifierTypeStateIssuer
1689779522OtherTXNPI-INDIVIDUAL

National Provider Directory

National Provider Directory

Locations

6012 W William Cannon Dr
Bldg C
Austin, TX 78749
Phone (512) 228-2852

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1871779256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91419",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787091419",
            "telephone_number": "512-899-8508",
            "fax_number": "512-899-9387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6012 W WILLIAM CANNON DR",
            "address_2": "BLDG C-101",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787491980",
            "telephone_number": "512-899-8508",
            "fax_number": "512-899-9387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNN JACKSON, PT, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-15",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-899-8508",
        "authorized_official_credential": "PT ,PC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1113850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI-INDIVIDUAL",
            "identifier": "1689779522",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.

Verify at the official NPI Registry.