Jamal D Jackson

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

4175 N Hanson CT Ste 301
Bowie, MD 20716-3186

Phone

(443) 481-1140

NPI assigned

Aug 16, 2018

Sex

Male

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)

Enrolled

Interoperability endpoints

• Direct secure messaging: jamal.jackson.1@14940.direct.athenahealth.com

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1891275137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6206 CHEVERLY PARK DR",
            "city": "CHEVERLY",
            "state": "MD",
            "postal_code": "207853050",
            "telephone_number": "301-789-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 N HANSON CT STE 301",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163186",
            "telephone_number": "443-481-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JAMAL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-16",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina Jabonete
• Jace Inc.
• Nurisha Shavon Jack, CNM
• Kia M Jackson-Garnett, MSW, LICSW, LCSW-C
• Anastasia Jackson
• Joyce Jackson, LMSW
• Tomesha Jackson, LCPC
• Yvonne Marie Jackson, M.D.
• Jacobs Audiology LLC
• Jacobs Promise

• Physical Therapist in Bowie, MD
• Providers in Bowie, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.