Individual provider Active NPI

Erick Laron Jackson, DPT

  • Physical Therapist
  • Buckeye, AZ
National Provider Identifier
1952730491
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP049850T Issued in AZ
Practice address
21250 W Roosevelt St Ste 106
Buckeye, AZ 85326-0313
Phone
(602) 648-5444
Fax
(602) 772-3801
NPI assigned
Nov 5, 2013
Last updated
Oct 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305208116 VA
Physical Therapist 225100000X CP049850T AZ Primary

Addresses

Primary practice location

21250 W Roosevelt St Ste 106
Buckeye, AZ 85326-0313

Mailing address

PO Box 80217
Phoenix, AZ 85060-0217
Phone (602) 385-2115

Other practice location 1

325 MDG/Physical Therapy
340 Magnolia Circle
Tyndall AFB, FL 32403
Phone (850) 283-7019

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251107002320 AZ Practitioner - Physical Therapist in Private Practice 6901396910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

21250 W Roosevelt St
Suite 106
Buckeye, AZ 85326-0313
Phone (602) 648-5444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP049850TAZMDPhysical Therapist
2305208116VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Specialists of North America PLLC Physical Therapist CurrentSince Oct 28, 2025 Accepting new patients
Orthopedic Specialists of North America, PLLC Current Accepting new patients
Orthopedic Specialists of North America, PLLC CurrentSince Oct 28, 2025 Accepting new patients

Locations

21250 W Roosevelt St
Ste 106
Buckeye, AZ 85326
Phone (602) 684-5444

40601 N Gantzel Rd
Ste 103
San Tan Vly, AZ 85140

5620 E Bell Rd
Scottsdale, AZ 85254
Phone (602) 485-3050

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1952730491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80217",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850600217",
            "telephone_number": "602-385-2115",
            "fax_number": "480-418-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21250 W ROOSEVELT ST STE 106",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853260313",
            "telephone_number": "602-648-5444",
            "fax_number": "602-772-3801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 MDG/Physical Therapy",
            "address_2": "340 Magnolia Circle",
            "address_purpose": "LOCATION",
            "city": "Tyndall AFB",
            "state": "FL",
            "postal_code": "32403",
            "country_code": "US",
            "telephone_number": "850-283-7019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ERICK",
        "middle_name": "LARON",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-05",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305208116",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "CP049850T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckeye, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.