MR. KEENAN JACKSON (NPI# 1073856779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073856779 |
| Entity Type | Individual |
| Full Name | MR. KEENAN JACKSON |
| Credential | OT |
| Practice Address |
6301 Forest Hills Dr Ne Albuquerque NM 87109-4137 |
| Practice Telephone | 5058238399 |
| Practice Fax Number | 5058238324 |
| Mailing Telephone | 5058238399 |
| Mailing Fax Number | 5058238324 |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2013-04-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | 3031 | NM | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427417906 | Keenan Jackson | Social Worker | 4449 N 12th St, Phoenix, AZ 85014-4520 | 2016-02-12 |
| Street Address |
6301 FOREST HILLS DR NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87109-4137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477629459 | Deana T Hartwig | Physical Therapy Assistant | 6301 Forest Hills Dr Ne, Albuquerque, NM 87109-4137 | 2006-11-28 |
| 1629465364 | Michele Dessalet | Physical Therapist | 6301 Forest Hills Dr Ne, Albuquerque, NM 87109-4137 | 2015-04-21 |
| 1902205644 | Stephanie Hines | Physical Therapist | 6301 Forest Hills Dr Ne, Albuquerque, NM 87109-4137 | 2014-08-19 |
| 1942635834 | Pratibha Anil Nirgudkar | Occupational Therapist | 6301 Forest Hills Dr Ne, Presbyterian Healthplex, Albuquerque, NM 87109-4137 | 2013-09-10 |
| 1649510413 | Helen Senesac | Physical Therapist | 6301 Forest Hills Dr Ne, Presbyterian Healthplex, Albuquerque, NM 87109-4137 | 2013-02-15 |
| 1467791137 | Mary E Cline | Physical Therapist | 6301 Forest Hills Dr Ne, Albuquerque, NM 87109-4137 | 2013-01-31 |
| 1730437302 | Ryan Coufal | Physical Therapist | 6301 Forest Hills Dr Ne, Albuquerque, NM 87109-4137 | 2012-08-29 |
| 1588921753 | Jamie Lynn Wilhelm | Physical Therapist | 6301 Forest Hills Dr Ne, Albuquerque, NM 87109-4137 | 2012-04-12 |
| 1366709537 | Steven Robert Saal | Physical Therapist | 6301 Forest Hills Dr Ne, Albuquerque, NM 87109-4137 | 2012-04-12 |
| 1952675647 | Ann Sockaci | Dietitian, Registered | 6301 Forest Hills Dr Ne, Albuquerque, NM 87109-4137 | 2012-02-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386286367 | Mikaela Epaloose | Behavior Technician | 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-10-11 |
| 1245872464 | Marsha Director | Behavior Technician | 100 Sun Avenue Ne, Ste 650, Albuquerque, NM 87109 | 2019-10-09 |
| 1720637499 | Nancy Gail Vice | Technician | 7319 Laguna Niguel Drive Ne, Albuquerque, NM 87109 | 2019-09-05 |
| 1598314411 | Chau Vu | Behavior Technician | Attn: Behavioral Health Works 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-09-04 |
| 1932753498 | Noelle Nielsen | Behavior Technician | 6401 Academy Rd. Ne Apt. 189, Albuquerque, NM 87109 | 2019-08-01 |
| 1952967952 | Caridad Merkel | Obstetrics & Gynecology | 6100 Pan American Fwy Ne Suite 450, Albuquerque, NM 87109 | 2019-05-15 |
| 1043795149 | Margaret Mcconville | Physical Therapist | Lovelace Women's Hospital Outpatient Rehabilitation, 4600 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-09-25 |
| 1922586262 | Clark Endodontics LLC | Dentist | 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, NM 87109 | 2018-07-30 |
| 1447736202 | Melissa Christine Scott | Registered Nurse | Lovelace Women's Hospital, 4701 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-07-16 |
| 1508351990 | Gianna Nicole Casarez-quintana | Dentist | 7520 Montgomery Blvd Ne Bldg E10, Albuquerque, NM 87109 | 2018-06-27 |
| Find all providers in zip 87109 | ||||
| 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 |
|---|---|---|---|---|
| 1568060432 | On The Map Therapy Servies LLC | Occupational Therapist | 7008 Calle Almeria Ne, Albuquerque, NM 87113-1095 | 2020-10-13 |
| 1750994216 | David Gleghorn | Occupational Therapist | 601 Arno St Se, Albuquerque, NM 87102-3903 | 2020-08-25 |
| 1407470008 | Maria Christine Soller | Occupational Therapist | 312 Broadway Blvd Ne, Albuquerque, NM 87102-3436 | 2020-05-31 |
| 1962031898 | Linda Wildemann | Occupational Therapist | 2709 Pan American Fwy Ne Ste J, Albuquerque, NM 87107-1650 | 2020-04-03 |
| 1932730686 | Kristin Kara White | Occupational Therapist | 708 California St Se, Albuquerque, NM 87108-3708 | 2020-01-31 |
| 1629610597 | Cima Ventures, LLC | Occupational Therapist | 10131 Coors Blvd Nw Ste H7, Albuquerque, NM 87114-4048 | 2019-10-11 |
| 1538717400 | Leighan Collins | Occupational Therapist | 618 Madison St Ne Apt B, Albuquerque, NM 87110-6274 | 2019-09-03 |
| 1215599725 | Michael Johnathan Miller | Occupational Therapist | 3131 Adams St Ne Apt E28, Albuquerque, NM 87110-8027 | 2019-07-03 |
| 1588220826 | Beverly Nicole Apodaca | Occupational Therapist | 6313 Barnhart St Ne, Albuquerque, NM 87109-3510 | 2019-05-13 |
| 1679137889 | Aubrey Alexander | Occupational Therapist | 8224 Dellwood Rd Ne, Albuquerque, NM 87110-2416 | 2019-04-24 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87109 |
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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.