MRS. JENNIFER BROCKMAN JACKSON (NPI# 1679792501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679792501 |
| Entity Type | Individual |
| Full Name | MRS. JENNIFER BROCKMAN JACKSON |
| Credential | OTR |
| Practice Address |
4101 28th Ave N Saint Petersburg FL 33713-2230 |
| Practice Telephone | 7275270703 |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | OT9272 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386738 | Jennifer O Jackson | Pharmacist | 1900 Ese Loop323, Tyler, TX 75701-8337 | 2020-11-05 |
| 1326655705 | Jennifer Nicole Jackson | Physical Therapy Assistant | 2540 Ridgeview Rd, Paris, TX 75460-3321 | 2020-09-29 |
| 1407461163 | Jennifer Jackson | Specialist/Technologist | 149 Flagstaff Dr, Bolingbrook, IL 60440-2657 | 2020-09-10 |
| 1689294829 | Jennifer K Jackson | Dietitian, Registered | 13017 Bear Dancer Trl Ne, Albuquerque, NM 87112-3726 | 2020-04-17 |
| 1285261479 | Jennifer Elizabeth Jackson | Pharmacist | 4675 W 37th Ave Apt 202, Denver, CO 80212-2079 | 2020-03-26 |
| 1487290524 | Jennifer Carol Jackson | Counselor | 76 Vassar St, Worcester, MA 01602-1535 | 2019-11-25 |
| 1275959348 | Jennifer Jackson | Dietitian, Registered | 101 Vinemont Dr, Lafayette, LA 70501-6579 | 2014-03-12 |
| 1013332535 | Jennifer Jackson | Speech-Language Pathologist | 1105 Mcmurdo Cir, Castle Rock, CO 80108-2821 | 2014-02-19 |
| 1891053526 | Jennifer Dawn Jackson | Counselor | 240 Orville Bates Ln, Estill Springs, TN 37330-4278 | 2012-05-01 |
| 1205149382 | Jennifer Lynn Lawrence Jackson | Pharmacist | 4718 Limestone Rd, Wilmington, DE 19808-1928 | 2010-07-19 |
| Street Address |
4101 28TH AVE N |
| City | SAINT PETERSBURG |
| State | FL |
| Zip Code | 33713-2230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073122230 | Busy Bee Aba Therapy LLC | Assistant Behavior Analyst | 441 33rd Street North #407, St. Petersburg, FL 33713 | 2020-07-23 |
| 1902428899 | Taylor Lorraine Fowler | Behavior Technician | 7381 114th Ave, Suite 405 Largo Fl 33773, Suite 405, St. Petersburg, FL 33713 | 2020-05-13 |
| 1770120180 | Mai Family and Sedation Dentistry, Pa | Dentist | 495 31st Street North, St. Petersburg, FL 33713 | 2019-12-04 |
| 1932672524 | Julie Marlowe Gilbert | Dermatology | 2191 9th Ave North, Ste. 100, St. Petersburg, FL 33713 | 2019-01-07 |
| 1962992024 | Lauren Elizabeth Oloughlin | Nurse Practitioner | 1001 37th St N Ste C, St Petersburg, FL 33713 | 2018-05-15 |
| 1447766316 | Melanie Marie Byrne | Assistant Behavior Analyst | 5185 45th St N, Bldg C, St. Petersburg, FL 33713 | 2017-12-14 |
| 1942679683 | Teresa E Peak | Physician Assistant | 2191 9th Ave N St 220, St. Petersburg, FL 33713 | 2015-09-23 |
| 1639555204 | Priya Panara | Internal Medicine | 2299 9th Ave N Ste 1f, St Petersburg, FL 33713 | 2015-08-06 |
| 1730568635 | Kevin Michael Carbonell | Dentist | 3863 Central Avenue, Saint Petersburg, FL 33713 | 2015-05-26 |
| 1558752972 | Sage Program, LLC | Community/Behavioral Health | 3530 1st Avenue North, Suite 111, St. Petersbrug, FL 33713 | 2015-02-06 |
| Find all providers in zip 33713 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730792706 | Jessica Marie Ernsthausen | Occupational Therapist | 3036 25th Ave N, Saint Petersburg, FL 33713-3826 | 2020-08-28 |
| 1790329316 | Suzanne L Murray | Occupational Therapist | 7500 4th St N Ste B, Saint Petersburg, FL 33702-5400 | 2019-11-06 |
| 1811543242 | Martin J Tunney | Occupational Therapist | 5912 5th Ave N, Saint Petersburg, FL 33710-7056 | 2019-08-12 |
| 1114497856 | Lauren Witsaman | Occupational Therapist | 5101 Brittany Dr S Ste 16, Saint Petersburg, FL 33715-1565 | 2018-11-26 |
| 1619498466 | Kirstie Tullis | Occupational Therapist | 1963 Burlington Ave N, Saint Petersburg, FL 33713-8030 | 2017-07-02 |
| 1477002996 | Alicia Kopp | Occupational Therapist | 909 64th St S, Saint Petersburg, FL 33707-3021 | 2016-09-26 |
| 1114386588 | Caroline Aita Mccoy | Occupational Therapist | 1501 Brightwaters Blvd Ne, Saint Petersburg, FL 33704-3811 | 2016-02-15 |
| 1003169020 | Stacy Foust Renz | Occupational Therapist | 8424 4th St N Ste G, Saint Petersburg, FL 33702-3654 | 2012-10-16 |
| 1235390279 | Maria R. Sessa Grantham | Occupational Therapist | 1428 32nd Ave N, Saint Petersburg, FL 33704-1947 | 2008-06-23 |
| 1376710186 | Jessica Chalker | Occupational Therapist | 820 Dartmoor St N, Saint Petersburg, FL 33701-2334 | 2008-05-12 |
| Find all providers in SAINT PETERSBURG | ||||
| City | SAINT PETERSBURG |
| Zip Code | 33713 |
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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.