Active NPI
Ronald Joseph Jackson, L.M.T.
- Massage Therapist
- Pagosa Springs, CO
National Provider Identifier
1972732717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 5112
- Practice address
- 450 Lewis St.
Pagosa Springs, CO 81147 - Phone
- (970) 264-2880
- NPI assigned
- Jul 14, 2009
- Last updated
- Jul 14, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 5112 | CO | Primary |
Addresses
Primary practice location
450 Lewis St.
Pagosa Springs, CO 81147
Mailing address
154 Woodsman Dr,
Pagosa Springs, CO 81147
Phone (970) 946-3426
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5112 | CO | MD | Rehabilitation Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247529600000",
"number": "1972732717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "154 WOODSMAN DR,",
"city": "PAGOSA SPRINGS",
"state": "CO",
"postal_code": "81147",
"telephone_number": "970-946-3426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 LEWIS ST.",
"city": "PAGOSA SPRINGS",
"state": "CO",
"postal_code": "81147",
"telephone_number": "970-264-2880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "RONALD",
"middle_name": "JOSEPH",
"credential": "L.M.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-14",
"last_updated": "2009-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CO",
"license": "5112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pagosa Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.