MR. KEITH R JACKSON OTR/L NPI 1003009937
Occupational Therapist in Leesburg, FL
About KEITH JACKSON
Keith Jackson is a provider established in Leesburg, Florida and his medical specialization is occupational therapist. The NPI number of Keith Jackson is 1003009937 and was assigned on August 2007. The practitioner's primary taxonomy code is 225X00000X with license number OT9471 (FL). The provider is registered as an individual and his NPI record was last updated 14 years ago.
Keith Jackson is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.
| NPI | 1003009937 |
| Provider Name | MR. KEITH R JACKSON OTR/L |
| Provider Location Address | 600 NORTH BLVD W SUITE D LEESBURG, FL 34748 |
| Provider Mailing Address | 4024 EAGLE RIDGE RD FRUITLAND PARK, FL 34731 |
| Gender | Male |
| NPI Entity Type | Individual |
| Is Sole Proprietor? | No |
| Is Organization Subpart? | N/A |
| Enumeration Date | 08-23-2007 |
| Last Update Date | 08-23-2007 |
Primary Taxonomy
| Taxonomy Code | 225X00000X |
| Classification | Occupational Therapist |
| Type | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| License No. | OT9471 |
| License State | FL |
| Taxonomy Description | 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. |
Business Address
MR. KEITH R JACKSON OTR/L
600 NORTH BLVD W
SUITE D
LEESBURG, FL
ZIP 34748
Phone: (352) 787-9300
Mailing Address
MR. KEITH R JACKSON OTR/L
4024 EAGLE RIDGE RD
FRUITLAND PARK, FL
ZIP 34731
Phone:
Other Providers at the same location
The following 15 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1265430003 | REHAB RX CORP Organization | Clinic/Center (Rehabilitation) | 600 NORTH BLVD W LEESBURG, FL 34748 (352) 728-6636 |
| 1174513428 | JOHN A COWIN M.D. Individual | Orthopaedic Surgery | 600 NORTH BLVD W SUITE C LEESBURG, FL 34748 (352) 728-3000 |
| 1346230596 | CARL O OLLIVIERRE M.D. Individual | Orthopaedic Surgery | 600 NORTH BLVD W SUITE C LEESBURG, FL 34748 (352) 728-3000 |
| 1396735544 | HARRY A HUNTT M.D. Individual | Orthopaedic Surgery | 600 NORTH BLVD W SUITE C LEESBURG, FL 34748 (352) 728-3000 |
| 1538196613 | MR. PEDRO ENRIQUE NAVARRO REGISTERED NURSE Individual | Registered Nurse (Administrator) | 600 NORTH BLVD W SUITE B LEESBURG, FL 34748 (352) 315-0050 |
| 1144414962 | MRS. KRISTINA JO DIX PTA Individual | Physical Therapy Assistant | 600 NORTH BLVD W SUITE D LEESBURG, FL 34748 (352) 787-9300 |
| 1235378654 | SUSAN EVATA SNYDER COTA Individual | Occupational Therapy Assistant | 600 NORTH BLVD W LEESBURG, FL 34748 (352) 728-6636 |
| 1871733717 | JAMES RANDALL DOCKHAM COTA Individual | Occupational Therapy Assistant | 600 NORTH BLVD W LEESBURG, FL 34748 (352) 728-6636 |
| 1427288208 | ELIZABETH ANN FYE PTA Individual | Physical Therapy Assistant | 600 NORTH BLVD W LEESBURG, FL 34748 (352) 728-6636 |
| 1639409246 | MS. ERIN MARIE BRECHEEN PTA Individual | Physical Therapy Assistant | 600 NORTH BLVD W LEESBURG, FL 34748 (352) 728-6636 |
| 1700163052 | MISS JACQUELINE CHRISTINE DELANEY PTA Individual | Physical Therapy Assistant | 600 NORTH BLVD W SUITE D LEESBURG, FL 34748 (352) 728-6636 |
| 1487926150 | ANGELA KRISTINE HACKEROTT PTA Individual | Physical Therapy Assistant | 600 NORTH BLVD W SUITE D LEESBURG, FL 34748 (352) 728-6636 |
| 1366641797 | DONNA LEIGH RIMA PTA Individual | Physical Therapy Assistant | 600 NORTH BLVD W SUITE D LEESBURG, FL 34748 (352) 728-6636 |
| 1164886891 | CHELSEA JOSEPH COTA Individual | Occupational Therapy Assistant | 600 NORTH BLVD W LEESBURG, FL 34748 (352) 787-9300 |
| 1912168170 | JENNIFER GOLDSTEIN GELB M. S. CCC-SLP Individual | Speech-Language Pathologist | 600 NORTH BLVD W SUITE D LEESBURG, FL 34748 (352) 728-6636 |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.