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KIM B JACKSON
NPI 1003415464
Massage Therapist in Glen Cove, NY

Active since October 18, 2020
29 GLEN COVE AVE STE 212, GLEN COVE, NY 11542(516) 384-7670 Get Directions Write a Review

NPPES record last updated: October 18, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kim B Jackson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIM B JACKSON (NPI 1003415464) is an individual massage therapist in Glen Cove, New York, licensed in New York (028858) and active in the NPI registry since October 2020.

NPPES Registry Identity

NPI1003415464
Entity TypeIndividualFemale
Primary Taxonomy225700000X
Provider Legal NameKIM B JACKSON
Location Address29 GLEN COVE AVE STE 212Glen Cove, NY 11542-2831
Mailing Address1360 C StElmont, NY 11003-3816 · (516) 384-7670
Phone(516) 384-7670
Sole ProprietorYes
Enumeration DateOctober 18, 2020
NPPES CertifiedOctober 18, 2020
✔ NPI 1003415464 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in NY · 028858
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.
29 GLEN COVE AVE STE 212, Glen Cove, NY 11542
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kim Jackson's NPI number?

The NPI number for Kim Jackson is 1003415464. It was assigned to this individual provider in the NPPES registry on October 18, 2020.

Where is Kim Jackson located?

Kim Jackson practices at 29 Glen Cove Ave Ste 212, Glen Cove, NY 11542. The listed phone number is (516) 384-7670.

What is Kim Jackson's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Kim Jackson was last updated on October 18, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.