Kathryn Elizabeth Jackson

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT006925 Issued in GA

Practice address

905 Arrowhead TRL
Warner Robins, GA 31088-5390

Phone

(478) 333-6363

Fax

(478) 666-6076

NPI assigned

Apr 6, 2018

Last updated

Feb 4, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Senseabilities, Inc.

  • Case Management Agency
  • Warner Robins, GA
  • NPI 1326395450
  NPD (past)

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1942707914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 ARROWHEAD TRL",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310885390",
            "telephone_number": "478-333-6363",
            "fax_number": "478-666-6076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 ARROWHEAD TRL",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310885390",
            "telephone_number": "478-333-6363",
            "fax_number": "478-666-6076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KATHRYN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-06",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT006925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003205498A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Zacharia Jackson
• Darla Jackson
• Delestin Jackson
• Elaine Jackson, NP
• Hunter Curtis Jackson, AGACNP
• Latoya Danielle Jackson, D.O.
• Leticia Jackson
• Mark Jackson Jr.
• Michael Frank Jackson Jr., DPT
• Princess Jackson

• Occupational Therapist in Warner Robins, GA
• Providers in Warner Robins, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; 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.