Individual provider Active NPI

Heather Aline Jackson

  • Audiologist
  • Hoover, AL
National Provider Identifier
1912424482
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1378A Issued in AL
Practice address
2161 Valleydale Rd
Hoover, AL 35244-2010
Phone
(205) 953-1569
Fax
(205) 987-3501
NPI assigned
Aug 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X FL
Audiologist 231H00000X
Audiologist 231H00000X 1378A AL Primary

Addresses

Primary practice location

2161 Valleydale Rd
Hoover, AL 35244-2010

Mailing address

550 N Reo St
Tampa, FL 33609-1061

Other practice location 1

550 N Reo St
Tampa, FL 33609-1061
Phone (813) 374-2070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250212000201 AL Practitioner - Qualified Audiologist 0648700211 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1378AALMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
J. Christopher Davis, PLLC CurrentSince Jan 2, 2025 Accepting new patients
ENT & Allergy Associates, P.C. PastSince Jul 7, 2024 Accepting new patients

Locations

2161 Valleydale Rd
Hoover, AL 35244
Phone (205) 988-6858

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/15dd2bda-9d00-4c3d-967c-f374acf8d6ab/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1912424482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 N REO ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2161 VALLEYDALE RD",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352442010",
            "telephone_number": "205-953-1569",
            "fax_number": "205-987-3501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 N Reo St",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336091061",
            "country_code": "US",
            "telephone_number": "813-374-2070",
            "fax_number": "813-337-0937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "HEATHER",
        "middle_name": "ALINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2024-07-01",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AL",
            "license": "1378A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoover, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.