Kyle G. Jackson, LMBT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

19362 Issued in NC

Practice address

5780 Ramsey St Ste 105
Fayetteville, NC 28311-1414

Phone

(910) 488-3322

NPI assigned

Jul 31, 2024

Last updated

Feb 7, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770422400000",
    "number": "1922837681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3739 COLORADO DR",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283482105",
            "telephone_number": "910-568-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5780 RAMSEY ST STE 105",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283111414",
            "telephone_number": "910-488-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KYLE",
        "middle_name": "G.",
        "credential": "LMBT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-31",
        "last_updated": "2026-02-07",
        "certification_date": "2026-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NC",
            "license": "19362",
            "primary": true
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Jackson, RD, LDN
• Johnathon Dean Jackson, LCSWA
• Jordan Lin Jackson, PT, DPT
• Kamya Jackson
• Kayla Jackson
• Lakya Jackson, M.S., BCBA-LBA
• Laura Jackson, LCSWA
• Lena Citirah Jackson, LCAS, LCMHC
• Maurice D Jackson, RBT
• Monique Dashelle Jackson, NCC, LCMHC-A, LCAS-A

• Massage Therapist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Massage Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2026; 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.