BEVERLY L JACKSON (NPI# 1891052619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891052619 |
| Entity Type | Individual |
| Full Name | BEVERLY L JACKSON |
| Credential | OTR/L |
| Practice Address |
1860 Pennsylvania Ave Mcdonough GA 30253-9117 |
| Mailing Address |
709 Crescent Cir Canton GA 30115-4772 |
| Practice Telephone | 6784621342 |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2012-04-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134608391 | Beverly J Jackson | Registered Nurse | 817 Briarcreek Dr, Baytown, TX 77521-3473 | 2018-08-08 |
| 1023548591 | Beverly Jackson | Nurse Practitioner | 608 Pine Pass Circle, Mineral Bluff, GA 30559 | 2017-06-15 |
| 1336465913 | Beverly P Jackson | Nutritionist | 19 Silk St, Norwalk, CT 06850-2916 | 2010-04-08 |
| 1891263125 | Beverly Jackson | Speech-Language Pathologist | 4511 Bestor Dr, Rockville, MD 20853-2100 | 2018-11-05 |
| 1154898468 | Beverly Jackson | Case Manager/Care Coordinator | 2017 Hudson Ln, Monroe, LA 71201-5705 | 2018-10-25 |
| 1871902247 | Beverly Jackson | Community Based Residential Treatment Facility, Mental Illness | 1100 W 6th Ave, Gary, IN 46402-1711 | 2014-08-10 |
| 1477814424 | Beverly Yvonne Jackson | Registered Nurse | 4212 N 16th St, Phoenix, AZ 85016-5319 | 2012-06-06 |
| 1245507813 | Beverly High Jackson | Pharmacist | 2950 S Blue Angel Pkwy, Pensacola, FL 32506-6905 | 2011-11-25 |
| 1750606539 | Beverly Anne Jackson | Counselor | 77 Cortland Ave, San Francisco, CA 94110-5435 | 2010-04-05 |
| 1134254618 | Beverly Jackson | Nurse Practitioner | 2065 Herschel St, Jacksonville, FL 32204-3817 | 2007-02-23 |
| Street Address |
1860 PENNSYLVANIA AVE |
| City | MCDONOUGH |
| State | GA |
| Zip Code | 30253-9117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164862116 | Kimmarchello Denise Baugh | Physical Therapist | 1860 Pennsylvania Ave, Mcdonough, GA 30253-9117 | 2013-07-04 |
| 1164763967 | Mavis Farmer | Speech-Language Pathologist | 1860 Pennsylvania Ave, Mcdonough, GA 30253-9117 | 2013-03-05 |
| 1477807410 | Kevin Morris | Occupational Therapist | 1860 Pennsylvania Ave, Mcdonough, GA 30253-9117 | 2012-10-29 |
| 1558613422 | Jill Weigel | Occupational Therapist | 1860 Pennsylvania Ave, Mcdonough, GA 30253-9117 | 2012-10-02 |
| 1386903789 | Mary C Hicks | Physical Therapist | 1860 Pennsylvania Ave, Mcdonough, GA 30253-9117 | 2012-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565159 | First Choice Home Health Care LLC | In Home Supportive Care | 600 Westridge Parkway, Suite 707, Mcdonough, GA 30253 | 2020-10-15 |
| 1164033783 | Tanequa S Dorsey | Counselor | 40 Macon Street, Suite D, Mcdonough, GA 30253 | 2020-08-17 |
| 1396369195 | Ikponmwosa Obakpolor | Physical Therapist | 234 Village Drive, Mcdonough, GA 30253 | 2020-06-08 |
| 1205392305 | Healthstat Onsite Clinic-henry County | Preventive Medicine | 141 Henry Parkway, Healthstat Clinic, Mcdonough, GA 30253 | 2019-02-13 |
| 1588128557 | Vernette R Mathurin | Licensed Practical Nurse | 97 Atl Street Suite 100, Mcdonough, GA 30253 | 2019-01-24 |
| 1083196836 | Peta-gaye C Pilote | Registered Nurse | 319 Regal Way E, Mcdonough, GA 30253 | 2018-08-29 |
| 1275021586 | Heritage Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 155 Westridge Pkwy Ste 217, Mcdonough, GA 30253 | 2018-04-23 |
| 1457853236 | Sherrille Greene | Counselor | 609 Autumn Leaf Circle, Mcdonough, GA 30253 | 2018-03-07 |
| 1376052696 | Kendra Oreggio | Private Vehicle | 117 Janney Circle, Mcdonough, GA 30253 | 2017-09-29 |
| 1245758788 | Pamela Hobbs | Home Health Aide | 5011 Monarch Dr, Mcdonough, GA 30253 | 2017-09-05 |
| Find all providers in zip 30253 | ||||
| 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 |
|---|---|---|---|---|
| 1578959433 | Larsen Brown | Occupational Therapist | 1350 Pennsylvania Ave, Mcdonough, GA 30253-9110 | 2015-04-07 |
| 1548554272 | Kerri Sheffield | Occupational Therapist | 1119 River Green Ct, Mcdonough, GA 30252-4596 | 2011-05-28 |
| 1619204278 | A Plus Medical Staffing LLC | Occupational Therapist | 249 Jonesboro Rd, Mcdonough, GA 30253-3769 | 2009-11-03 |
| 1144487117 | Alpa A Panchal | Occupational Therapist | 166 Glen Eagle Way, Mcdonough, GA 30253-4227 | 2008-05-19 |
| 1033251764 | Mary Subra | Occupational Therapist | 191 Pittypat Pl, Mcdonough, GA 30253-5554 | 2007-02-12 |
| 1902846884 | Felicia Mathis | Occupational Therapist | 537 Cold Water Ln, Mcdonough, GA 30252-8066 | 2006-06-07 |
| 1114536620 | Cynthia Buttler | Occupational Therapist | 1350 Pennsylvania Ave, Mcdonough, GA 30253-9110 | 2020-07-30 |
| 1205458858 | Tetisheri Menna | Occupational Therapist | 1350 Pennsylvania Ave, Mcdonough, GA 30253-9110 | 2020-05-16 |
| 1740837251 | Independent Physical Therapy of Ga LLC | Occupational Therapist | 5948 E Lake Pkwy, Mcdonough, GA 30253-4802 | 2019-08-20 |
| 1699211896 | Jena Segrest | Occupational Therapist | 1350 Pennsylvania Ave, Mcdonough, GA 30253-9110 | 2017-01-11 |
| Find all providers in MCDONOUGH | ||||
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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.