MRS. CHRYSTAL MAE JACKSON (NPI# 1841782398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841782398 |
| Entity Type | Individual |
| Full Name | MRS. CHRYSTAL MAE JACKSON |
| Other Name | MRS. CHRYSTAL MAE WOLVEN |
| Credential | COTA |
| Practice Address |
5417 Altamesa Blvd Fort Worth TX 76123-2804 |
| Mailing Address |
640 Bent Oak Dr Fort Worth TX 76131-4230 |
| Practice Telephone | 8669802475 |
| Mailing Telephone | 8064338191 |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2018-05-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224Z00000X | Occupational Therapy Assistant | 210256 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003262338 | Chrystal Bennett Jackson | Specialist | 13923 S Haystack Peak Cir, Riverton, UT 84096-6453 | 2016-05-05 |
| Street Address |
5417 ALTAMESA BLVD |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76123-2804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689715351 | Bethesda Foundation | Assisted Living Facility | 5417 Altamesa Blvd, Fort Worth, TX 76123-2804 | 2007-02-08 |
| 1720699697 | Missy Anne Rodriguez | Physical Therapist | 5417 Altamesa Blvd, Fort Worth, TX 76123-2804 | 2020-08-13 |
| 1942823133 | Kelli White | Physical Therapist | 5417 Altamesa Blvd, Fort Worth, TX 76123-2804 | 2020-05-21 |
| 1083250625 | Patricia M Sammons | Occupational Therapy Assistant | 5417 Altamesa Blvd, Fort Worth, TX 76123-2804 | 2019-11-19 |
| 1427571538 | Megan S Smith | Occupational Therapy Assistant | 5417 Altamesa Blvd, Fort Worth, TX 76123-2804 | 2017-07-20 |
| 1285188193 | Kiley Beard | Physical Therapy Assistant | 5417 Altamesa Blvd, Fort Worth, TX 76123-2804 | 2016-08-09 |
| 1700244258 | Jennifer Elliott | Occupational Therapy Assistant | 5417 Altamesa Blvd, Fort Worth, TX 76123-2804 | 2016-01-29 |
| 1417384702 | Mireya Hernandez Chadwick | Speech-Language Pathologist | 5417 Altamesa Blvd, Fort Worth, TX 76123-2804 | 2013-10-01 |
| 1326321035 | Rosa Anderson | Physical Therapy Assistant | 5417 Altamesa Blvd, Fort Worth, TX 76123-2804 | 2011-09-20 |
| 1588973994 | Paige M Preston | Speech-Language Pathologist | 5417 Altamesa Blvd, Fort Worth, TX 76123-2804 | 2010-10-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205440146 | Ismile Dental At The Chisolm Trail Pllc | Dentist | 5513 Sycamore School Rd, Fort Worth, TX 76123 | 2020-09-08 |
| 1558916361 | Nimu Pllc | Dentist | 5325 Mcpherson Blvd, Suite 120, Fort Worth, TX 76123 | 2019-08-08 |
| 1306361431 | Kelley Phillips | Counselor | 5013 Pallas Court, Fort Worth, TX 76123 | 2017-08-09 |
| 1396280756 | Chisholm Trail Emergency Center | Clinic/Center | 5500 Sycamore School Rd., Ste. 150, Fort Worth, TX 76123 | 2016-12-21 |
| 1457801391 | Point of Grace Home Health | Registered Nurse | 2533 Mill Spring Pass, Fort, TX 76123 | 2016-10-04 |
| 1992253306 | Jason Bowers | Specialist/Technologist, Other | 5316 Quail Feather Dr, Fort Worth, TX 76123 | 2016-09-14 |
| 1831546944 | Kalima Charway | Psychologist | 4532 Endercrest Lane, Fort Worth, TX 76123 | 2016-05-18 |
| 1033551577 | Michael Rose | Specialist | 4924 Belladonna Dr, Fort Worth, TX 76123 | 2013-07-25 |
| 1265871768 | Anna Uppal | Dentist | 100 Wolfe Nursery Street, 180, Stephenville, TX 76123 | 2013-06-18 |
| 1366880627 | Mesa Springs, LLC | Psychiatric Hospital | 5560 Mesa Springs Drive, Fort Worth, TX 76123 | 2013-06-10 |
| Find all providers in zip 76123 | ||||
| Taxonomy Code | 224Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapy Assistant |
| An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examination for occupational therapy assistants, and fulfills state requirements for licensure, certification, or registration. An occupational therapy assistant provides interventions under the supervision of an occupational therapist 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 therapy assistants 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, source changed] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942847181 | Lindsey Parish | Occupational Therapy Assistant | 7008 Golden Gate Dr E, Fort Worth, TX 76132-3702 | 2019-12-06 |
| 1437796299 | Latalia Lashaye Harrison | Occupational Therapy Assistant | 7810 Downe Dr, Fort Worth, TX 76108-3230 | 2019-11-28 |
| 1083262935 | Kristian Ashley Ray | Occupational Therapy Assistant | 1050 Lake View Rdg, Fort Worth, TX 76108-3023 | 2019-09-03 |
| 1861962839 | Erika Word | Occupational Therapy Assistant | 6251 Overton Ridge Blvd, Fort Worth, TX 76132-3755 | 2018-12-03 |
| 1164919460 | April Reed | Occupational Therapy Assistant | 1300, 2400 Westport Pkwy, Fort Worth, TX 76247 | 2018-04-23 |
| 1992201024 | Kathia Guerrier | Occupational Therapy Assistant | 4141 S Hulen St Apt 1127, Fort Worth, TX 76109-4972 | 2018-04-05 |
| 1023525573 | Jennifer Christine Arriaga | Occupational Therapy Assistant | 125 Smallwood, Fort Worth, TX 76114 | 2018-01-05 |
| 1043744691 | Dyann Harris | Occupational Therapy Assistant | 7732 Grassland Dr, Fort Worth, TX 76133-7922 | 2017-04-19 |
| 1801335831 | Traci Taylor | Occupational Therapy Assistant | 8120 Kathleen Dr, Fort Worth, TX 76137-6112 | 2017-02-23 |
| 1437600673 | Cassandra Wood | Occupational Therapy Assistant | 201 W Lancaster Ave, Unit 210, Fort Worth, TX 76102-6663 | 2016-10-24 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76123 |
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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.