MATTHEW JACKSON (NPI# 1992027775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992027775 |
| Entity Type | Individual |
| Full Name | MATTHEW JACKSON |
| Credential | DPT, MOT,ATC |
| Practice Address |
187 Ninth St Jena LA 71342-2780 |
| Mailing Address |
187 Ninth St Jena LA 71342 |
| Practice Telephone | 3189929200 |
| Practice Fax Number | 3189929280 |
| Mailing Telephone | 3189929200 |
| Mailing Fax Number | 3189929280 |
| Enumeration Date | 2010-02-22 |
| Last Update Date | 2010-02-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | 07464 | LA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
07464 | LA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 225X00000X | Occupational Therapist | 07464 | LA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | LA STATE LICENSE | 07464 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184278913 | Matthew Jackson | Student in an Organized Health Care Education/Training Program | 540 W 5150 S, Washington Terrace, UT 84405-6530 | 2019-07-30 |
| 1922651041 | Matthew Jackson | Social Worker | 1820 Pleasant Dr, Portage, MI 49002-5604 | 2019-07-17 |
| 1093289795 | Matthew Kory Jackson | Chiropractor | 515 E 4500 S Ste G230, Salt Lake City, UT 84107-4510 | 2019-01-15 |
| 1932558210 | Matthew Jackson | Driver | 3121 Johnston St Apt 142, Lafayette, LA 70503-3760 | 2016-06-08 |
| 1306237201 | Matthew Jackson | Specialist/Technologist | 51 Edward Rd, Townsend, MA 01469-1107 | 2015-02-12 |
| 1710235452 | Matthew Kane Jackson | Pharmacist | 942 Loy Cemetery Rd, Columbia, KY 42728-8719 | 2012-08-28 |
| 1619103702 | Matthew Matthew Jackson | Case Manager/Care Coordinator | 1101 West Morgan St, Suite 8, Paragould, AR 72450-3949 | 2009-06-03 |
| 1609942531 | Matthew Bryan Jackson | Massage Therapist | 2600 Sw Barton Street, Suite A24, Seattle, WA 98126 | 2006-11-24 |
| 1962481887 | Matthew Dv Jackson | Dentist | 9319 E Harry, #126, Wichita, KS 67207 | 2006-01-10 |
| 1528590460 | Matthew Dean Jackson | Student in an Organized Health Care Education/Training Program | 571 S Floyd St, Ste 412, Louisville, KY 40202-3818 | 2017-03-30 |
| Street Address |
187 NINTH ST |
| City | JENA |
| State | LA |
| Zip Code | 71342-2780 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962493601 | Roy Steven Johnson | Nurse Anesthetist, Certified Registered | 187 Ninth St, Jena, LA 71342-3901 | 2005-11-02 |
| 1205217064 | Clint Cooksey | Nurse Practitioner | 187 Ninth St, Jena, LA 71342-3900 | 2015-06-17 |
| 1235522871 | Hospital Service District #2 of Lasalle Parish | Ambulance | 187 Ninth St, Jena, LA 71342-3900 | 2015-03-06 |
| 1336435387 | Jereme Brian Johnson | Physical Medicine & Rehabilitation | 187 Ninth St, Jena, LA 71342-2780 | 2011-06-28 |
| 1265626477 | Patrice P Flaherty | General Practice | 187 Ninth St, Jena, LA 71342-3901 | 2007-08-30 |
| 1710004189 | Amanda Price | Speech-Language Pathologist | 187 Ninth St, Jena, LA 71342-2780 | 2007-03-23 |
| 1174640056 | Jamie R. Tubre | Pharmacist | 187 Ninth St, Jena, LA 71342-2780 | 2007-03-23 |
| 1760509152 | Lisa Deville | Pharmacy Technician | 187 Ninth St, Jena, LA 71342-2780 | 2007-03-23 |
| 1285751644 | Julie Bird | Occupational Therapist | 187 Ninth St, Jena, LA 71342-2780 | 2007-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881218162 | Just Health | Clinic/Center | 2083 S 2nd St, Jena, LA 71342 | 2020-06-03 |
| 1730722471 | Dm Properties of Lafayette, LLC | Clinic/Center | 3662 W Oak St, Jena, LA 71342 | 2019-10-25 |
| 1184160335 | Ashley Smith | Counselor | 842 W Bradford St, Jena, LA 71342 | 2017-01-12 |
| 1922452788 | Sandra Melvin | Case Manager/Care Coordinator | 3683 Hwy 127 South, Jena, LA 71342 | 2016-04-19 |
| 1962860478 | Jennifer Allemand | Case Manager/Care Coordinator | 3683 S First Street, Jena, LA 71342 | 2016-01-29 |
| 1801253521 | Jasmine Furlow | Counselor | 842 West Bradford, Jena, LA 71342 | 2016-01-26 |
| 1760855035 | Kathryn Long | Case Manager/Care Coordinator | 3863 South First Street, Jena, LA 71342 | 2015-11-09 |
| 1417207200 | Mayo Physical Therapy LLC | Clinic/Center | 12023 Highway 84 West, Jena, LA 71342 | 2012-09-19 |
| 1568736718 | Laverne M Paul | Counselor | 1737 N.2nd Street, Suite B, Jena, LA 71342 | 2012-03-06 |
| 1528359163 | Rebecca W Zeagler | Chiropractor | 12051 Hwy 84 W, Jena, LA 71342 | 2011-05-01 |
| Find all providers in zip 71342 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346848116 | Kerry Michael Ruiz | Specialist/Technologist | 2378 Kensington Dr, Baton Rouge, LA 70809-1210 | 2020-10-14 |
| 1013514710 | Jody Powell | Specialist/Technologist | 1600 Arizona Ave, Monroe, LA 71202-3602 | 2020-10-06 |
| 1336755495 | Kevin Keys | Specialist/Technologist | 106 Tomahawk Dr, Lafayette, LA 70503-6606 | 2020-09-23 |
| 1770199531 | Ryan Petrossi | Specialist/Technologist | 11959 Nicholson Dr Apt 17304, Baton Rouge, LA 70810-7626 | 2020-09-17 |
| 1285240028 | Cecilia Kieliszewski | Specialist/Technologist | 308 Warhawk Way Ulm Athletics Department, Monroe, LA 71209-0001 | 2020-09-17 |
| 1659985596 | Jake Bradley Lipps | Specialist/Technologist | 40068 Davis Dr, Ponchatoula, LA 70454-6410 | 2020-09-08 |
| 1942811773 | William Connor Sinclair | Specialist/Technologist | 12019 Fairview Way, Saint Francisville, LA 70775-7464 | 2020-08-14 |
| 1336750306 | Margaret Anne Schladenhauffen | Specialist/Technologist | 131 S Jeff Davis Pkwy Unit 100, New Orleans, LA 70119-6227 | 2020-08-13 |
| 1457962847 | Alexa Yanez | Specialist/Technologist | 936 Elmeer Ave, Metairie, LA 70005-1612 | 2020-08-11 |
| 1609486885 | Jasmine Joane Anderson | Specialist/Technologist | 1228 S Genois St, New Orleans, LA 70125-1724 | 2020-08-03 |
| Find all providers with the same taxonomy | ||||
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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.