Jennifer Whitener Jackson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A2526 Issued in NC

Practice address

2778 Country Club Dr
Hampstead, NC 28443-8028

Phone

(910) 270-1443

NPI assigned

Apr 7, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1982346201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 PHAESON PL",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279097765",
            "telephone_number": "828-234-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2778 COUNTRY CLUB DR",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284438028",
            "telephone_number": "910-270-1443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JENNIFER",
        "middle_name": "WHITENER",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A2526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Ann Iman, M.S., CCC-SLP
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• Darrian Nicole Ivey
• Yoneida Izaguirre
• Lindsey E James de la Rosa Buglewicz, LRT, CTRS
• Melissa Eve Jaworowski, LCMHCA
• Deborah Sue Jenks, DNP, PMHNP-BC, FNP-C
• Nicholas Allen Jernigan, M.D.
• Johnson Drug Hampstead

• Physical Therapy Assistant in Hampstead, NC
• Providers in Hampstead, NC by specialty
• Physical Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.