MRS. TARA MICHELE JACKSON (NPI# 1114973559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114973559 |
| Entity Type | Individual |
| Full Name | MRS. TARA MICHELE JACKSON |
| Credential | MA, CCC-SLP |
| Practice Address |
3403 Linden Berry Ln Charlotte NC 28269-1300 |
| Mailing Address |
3403 Linden Berry Lane Charlotte NC 28269-1300 |
| Practice Telephone | 7042581724 |
| Practice Fax Number | 7045983024 |
| Mailing Telephone | 7048982437 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2011-07-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 5772 | NC | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7412438 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144632837 | Tara Jackson | Physical Therapy Assistant | 303 North Hurstbourne Parkway, Suite 200, Louisville, KY 40222 | 2014-05-29 |
| 1578900510 | Tara M Jackson | Counselor | 1911 Main Ave Ste 248, Durango, CO 81301-5077 | 2013-05-31 |
| 1578784245 | Tara M Jackson | Developmental Therapist | 104 G Corum Ln, Auburn, KY 42206-5000 | 2007-05-01 |
| 1578164679 | Tara Jackson | Behavior Technician | 6013 S Redwood Rd, Taylorsville, UT 84123-5220 | 2020-11-04 |
| 1124583653 | Tara Y. Jackson | Registered Nurse | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2019-02-08 |
| 1184076812 | Tara Jackson | Behavioral Analyst | 260 Peachtree St Nw Ste 2200, Atlanta, GA 30303-1292 | 2016-07-06 |
| 1790028082 | Tara Leigh Jackson | Nurse Practitioner | 123 James River & Kanawha Turnpike, Ansted, WV 25812 | 2013-04-04 |
| 1750630505 | Tara Jackson | Pharmacist | 4353 W Bethany Home Rd, Glendale, AZ 85301-5483 | 2012-09-06 |
| 1184979098 | Tara Jackson | Nurse Practitioner | 6675 Holmes Rd, Suite 400, Kansas City, MO 64131-1150 | 2012-07-17 |
| 1992081343 | Tara Renae Jackson | Nurse Anesthetist, Certified Registered | 13737 Noel Rd, Ste 1400, Dallas, TX 75240-2004 | 2011-10-31 |
| Street Address |
3403 LINDEN BERRY LN |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28269-1300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548259187 | Margaret Moore | Speech-Language Pathologist | 3403 Linden Berry Ln, Charlotte, NC 28269-1300 | 2005-10-17 |
| 1508104431 | Linda Alger | Speech-Language Pathologist | 3403 Linden Berry Ln, Charlotte, NC 28269-1300 | 2013-01-28 |
| 1225210586 | Christie Carson | Physical Therapist | 3403 Linden Berry Ln, Charlotte, NC 28269-1300 | 2007-11-28 |
| 1912198839 | Ashley Louise Przybyszewski | Speech-Language Pathologist | 3403 Linden Berry Ln, Charlotte, NC 28269-1300 | 2007-08-06 |
| 1336284009 | Amy Denise Austin | Speech-Language Pathologist | 3403 Linden Berry Ln, Charlotte, NC 28269-1300 | 2007-02-21 |
| 1962545095 | Meredith A. Gerbino | Speech-Language Pathologist | 3403 Linden Berry Ln, Charlotte, NC 28269-1300 | 2007-02-15 |
| 1154467371 | Michelle Hughes Collis | Speech-Language Pathologist | 3403 Linden Berry Ln, Charlotte, NC 28269-1300 | 2007-01-29 |
| 1831246495 | Kathleen Anne Lane | Speech-Language Pathologist | 3403 Linden Berry Ln, Charlotte, NC 28269-1300 | 2007-01-05 |
| 1285790683 | Cortney Steele Walker | Occupational Therapist | 3403 Linden Berry Ln, Charlotte, NC 28269-1300 | 2006-12-29 |
| 1942286372 | Pediatric Theraplay Speech Services, Inc. | Occupational Therapist | 3403 Linden Berry Ln, Charlotte, NC 28269-1300 | 2005-12-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124664438 | Alluring Occupational Therapy Services, Pllc | Occupational Therapy Assistant | 3020-i Prosperity Church Rd, Ste 523, Charlotte, NC 28269 | 2019-11-21 |
| 1366085094 | Crystal R Currie | Counselor | 8824 Cliff Cameron Drive, Uint 107, Charlotte, NC 28269 | 2019-10-25 |
| 1477102879 | Apryl N. Davis | Occupational Therapy Assistant | 3020-i Prosperity Church Rd., Charlotte, NC 28269 | 2019-09-09 |
| 1730744202 | Christopher Paige | Driver | 9805 Statesville Rd., Suite 6198, Charlotte, NC 28269 | 2019-05-09 |
| 1619532892 | Krb Support Services | Prevention Professional | 11634 Oak Street, Charlotte, NC 28269 | 2019-05-03 |
| 1184186769 | Kimberly M Lynch | Local Education Agency (LEA) | 11634 Oat Street, Charlotte, NC 28269 | 2019-04-03 |
| 1356802318 | Arleen M Blythe | Physical Therapy Assistant | 1521 Bucklebury Ct, Charlotte, NC 28269 | 2019-03-30 |
| 1174089064 | Quality Behavioral Health Services, Pllc | Social Worker | 9805 Statesville Rd, # 6095, Charlotte, NC 28269 | 2019-02-15 |
| 1326517855 | Mary Frances Pickens-wilson | Behavior Technician | 4628 Quinton Lane, Charlotte, NC 28269 | 2018-11-14 |
| 1548746605 | Tiffany Michelle Graham | Counselor | 9823 Cooper Run Ln, Charlotte, NC 28269 | 2018-07-12 |
| Find all providers in zip 28269 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396345112 | Good Shepherd Therapy | Speech-Language Pathologist | 10301 Oak Pond Cir, Charlotte, NC 28277-9506 | 2020-10-30 |
| 1922616036 | Mila Therapy Services | Speech-Language Pathologist | 14165 Dunbritton Ln Apt 1312, Charlotte, NC 28277-2452 | 2020-07-15 |
| 1437776309 | Anna Hardison | Speech-Language Pathologist | 9934 Meadowmead Ct, Charlotte, NC 28273-3367 | 2020-06-26 |
| 1063056968 | Susanna Eleanor Wooten | Speech-Language Pathologist | 16147 Lancaster Hwy Ste 130, Charlotte, NC 28277-2051 | 2019-11-04 |
| 1326696345 | Elizabeth Jane Buie | Speech-Language Pathologist | 5928 Winburn Ln, Charlotte, NC 28226-8152 | 2019-09-03 |
| 1053967398 | Marissa Pardini | Speech-Language Pathologist | 101 E Wt Harris Blvd Ste 5100, Charlotte, NC 28262-3485 | 2019-08-13 |
| 1003469008 | Lauren Jane Cownie | Speech-Language Pathologist | 523 Ridgeway Ave Apt 101, Charlotte, NC 28204-0023 | 2019-07-18 |
| 1558914838 | Margaret Thompson Fitzgerald | Speech-Language Pathologist | 1205 S Tryon St Unit 1448, Charlotte, NC 28203-4393 | 2019-07-16 |
| 1386205763 | Alyssa Dudley | Speech-Language Pathologist | 1331 W Morehead St Apt 544, Charlotte, NC 28208-5391 | 2019-06-26 |
| 1992262018 | Katherine Grace Bias | Speech-Language Pathologist | 11709 Freuhaud Dr Ste. 123, Charlotte, NC 28273 | 2019-02-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.