Active NPI
Lisa Michelle Jackson, OTR-L
- Occupational Therapist
- Milton, MA
National Provider Identifier
1881273365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 9925
- Practice address
- 138 Thacher St
Milton, MA 02186-2025 - Phone
- (617) 910-8923
- NPI assigned
- Apr 3, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 9925 | MA | Primary |
Addresses
Primary practice location
138 Thacher St
Milton, MA 02186-2025
Mailing address
138 Thacher St
Milton, MA 02186-2025
Phone (617) 910-8923
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9925 | MA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617408000000",
"number": "1881273365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "138 THACHER ST",
"city": "MILTON",
"state": "MA",
"postal_code": "021862025",
"telephone_number": "617-910-8923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "138 THACHER ST",
"city": "MILTON",
"state": "MA",
"postal_code": "021862025",
"telephone_number": "617-910-8923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "LISA",
"middle_name": "MICHELLE",
"credential": "OTR-L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-03",
"last_updated": "2021-04-03",
"certification_date": "2021-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "9925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.