Freddie Jackson

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Practice address

3819 Happy Canyon Dr
Dallas, TX 75241-5230

Phone

(978) 962-9754

NPI assigned

Jun 17, 2024

Sex

Male

Sole proprietor

Yes

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

Practice roles

Locations

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.

• King Ministriez

  • Home Health Agency
  • Dallas, TX
  • NPI 1720821820
  NPD Authorized official

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1881437986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3655 SIMPSON STUART RD UNIT 41324",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752414346",
            "telephone_number": "978-962-9754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3819 HAPPY CANYON DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752415230",
            "telephone_number": "978-962-9754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "FREDDIE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dianna E Jackson, LMT
• Elisabeth Vennecia Jackson, M.D.
• Emily Jackson, DC
• Erica Jackson, DPT
• Franklin Jackson III
• Gregory Lawrence Jackson, MD
• Heaven Jackson
• Jacqueline Kay Jackson, LCDC
• Jenner Philip Jackson
• Jennifer Jackson, APRN, NP-C

• Home Health Agency in Dallas, TX
• Providers in Dallas, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.