KELLY JACKSON


Address: 1325 San Marco Blvd, Suite 102, Jacksonville, FL 32207-8568
Phone: 9048587045

KELLY JACKSON (NPI# 1497108310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1497108310
Entity Type Individual
Full Name KELLY JACKSON
Other Name KELLY ABDULLAH
Credential LMT
Practice Address 1325 San Marco Blvd
Suite 102
Jacksonville
FL 32207-8568
Practice Telephone 9048587045
Mailing Telephone 9048587045
Enumeration Date 2016-07-15
Last Update Date 2016-07-15
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 225700000X Massage Therapist MA61239 FL Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Other Providers KELLY JACKSON

NPI Name Taxonomy Address Enumeration
1588036263 Kelly Jackson Social Worker 2937 Ne 16th Ter, Gainesville, FL 32609-3234 2015-10-21
1477896876 Kelly A Jackson Occupational Therapist 178 Manila Ave, Staten Island, NY 10306-5608 2013-04-03
1104986793 Kelly A Jackson Chiropractor 190 North Main Street, Natick, MA 01760 2006-12-12
1518982487 Kelly Donald Jackson Dentist 3023 Eastland Blvd Ste 112, Clearwater, FL 33761-4106 2006-07-13
1689273310 Kelly Jackson Behavior Technician 27777 Inkster Rd Ste 100, Farmington Hills, MI 48334-5312 2020-10-23
1629544655 Kelly Colleen Jackson Counselor 811 Madison St, Everett, WA 98203-4543 2018-10-17
1619457926 Kelly Jackson Physician Assistant 12300 Mccracken Rd, Garfield Heights, OH 44125-2975 2018-08-16
1760961833 Kelly D Jackson Licensed Practical Nurse 602 W Semands St, Conroe, TX 77301-1867 2018-08-09
1841780178 Kelly Amanda Jackson Nurse Practitioner 1700 Medical Center Pkwy, Murfreesboro, TN 37129-2245 2018-05-11
1033653431 Kelly Jackson Nurse Practitioner 606 W Columbia St, San Augustine, TX 75972-1709 2016-12-05

Office Location

Street Address 1325 SAN MARCO BLVD
SUITE 102
City JACKSONVILLE
State FL
Zip Code 32207-8568

Providers in the same location

NPI Name Taxonomy Address Enumeration
1730183500 Philip R. Hardy Orthopaedic Surgery 1325 San Marco Blvd, Ste 200, Jacksonville, FL 32207-8566 2005-06-09
1730794496 Rachel Keene Specialist/Technologist 1325 San Marco Blvd, Jacksonville, FL 32207-8568 2020-09-10
1396201638 Neutt Dellareeda King Nurse Practitioner 1325 San Marco Blvd, Jacksonville, FL 32207-8568 2019-02-12
1396282836 Peter Christopher Mcdermott Nurse Practitioner 1325 San Marco Blvd, 300, Jacksonville, FL 32207-8568 2017-01-23
1215472014 Lindsay Moore Nurse Practitioner 1325 San Marco Blvd, Reid Building Ste 300, Jacksonville, FL 32207-8568 2017-01-03
1659828994 Aimee Roberts-serrato Nurse Practitioner 1325 San Marco Blvd, Suite 200, Jacksonville, FL 32207-8568 2016-09-03
1265985030 Laran Phelps Massage Therapist 1325 San Marco Blvd, Suite 102, Jacksonville, FL 32207-8568 2016-07-28
1376902221 Joshua Jackson Nurse Practitioner 1325 San Marco Blvd, Reid Bldg., Suite 300, Jacksonville, FL 32207-8568 2016-02-21
1063889814 Emily Lisa Rea Nurse Practitioner 1325 San Marco Blvd, Reid Building Suite 300, Jacksonville, FL 32207-8568 2015-08-27
1194192153 Venessa Carmel Physical Therapist 1325 San Marco Blvd, Suite 102, Jacksonville, FL 32207-8568 2015-08-26
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1033768981 North Florida Pediatrics, Pa Pediatrics 4501 Atlantic Boulevard, Jacksonville, FL 32207 2019-09-04
1578117024 Pragna Mukesh Dholakia Nurse Practitioner 2624 Atlantic Blvd., Jacksonville, FL 32207 2019-08-01
1821653601 The Adoption Authority, Inc. Case Management 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 2019-05-07
1255896080 Elizabeth Lynn Houghton Social Worker Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 2019-02-06
1902374630 Guilherme Jose Agnoletto Neurological Surgery 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 2018-11-12
1073008504 Pavilion Infusion Therapy Inc Durable Medical Equipment & Medical Supplies 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 2018-06-27
1346733185 Dueseason1 Registered Nurse 4058 Saint Augustine Rd, Jacksonville, FL 32207 2018-06-06
1164911913 Eric Lang Poovey Nurse Practitioner Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 2018-05-08
1902311046 Spring Park Pharmacy LLC Durable Medical Equipment & Medical Supplies 3851 Emerson St Ste 13, Jacksonville, FL 32207 2017-12-12
1295247948 Emed Urgent and Primary Care Pa Clinic/Center 2570 Atlantic Boulevard, Jacksonville, FL 32207 2017-11-02
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Taxonomy Information

Taxonomy Code 225700000X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Massage Therapist

Taxonomy Definition

An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1376142299 Undra Williams Massage Therapist 5900 Townsend Rd Apt 813, Jacksonville, FL 32244-4579 2020-10-21
1356958771 Jared Franklin Massage Therapist 1540 El Prado Rd Apt 1, Jacksonville, FL 32216-2965 2020-09-29
1043826613 Eric Gene Thompson Massage Therapist 2386 Villanova Cir # Na, Jacksonville, FL 32218-5123 2020-09-19
1720693757 Cathleen Ann Smith Massage Therapist 13051 Gran Bay Pkwy Unit 2321, Jacksonville, FL 32258-6520 2020-09-15
1720693286 Paul Andrew Hudson Massage Therapist 13108 Harborton Dr, Jacksonville, FL 32224-7403 2020-09-11
1063026748 Sandra Nicole Frye Massage Therapist 5894 Long Branch Rd, Jacksonville, FL 32234 2020-09-01
1104437821 Crystal Delgado Mccraw Massage Therapist 869 Stockton St Ste 8, Jacksonville, FL 32204-3590 2020-08-14
1538787866 Tywanna Council Massage Therapist 4720 Salisbury Road #102, Jacksonville, FL 32256 2020-07-13
1659904514 Kyoko Provencio Massage Therapist 136 Gregory Pl, Jacksonville, AR 72076-3212 2020-02-19
1750933529 James Bradley Toon Massage Therapist 12443 San Jose Blvd Ste 801, Jacksonville, FL 32223-8654 2019-07-11
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Competitor

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City JACKSONVILLE
Zip Code 32207

Improve Information

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Dataset Information

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.

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