DR. ERICK LARON JACKSON (DPT) – Physical Therapist, NPI 1952730491
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,633 PHYSICAL THERAPIST IN PRIVATE PRACTICE in FL
Provider Addresses for DR. ERICK LARON JACKSON (DPT)
325 MDG/PHYSCIAL THERAPY
340 MAGNOLIA CIRCLE
TYNDALL AFB, FL 32403
Phone: (850) 283-7019
Type: Mailing
325 MDG/Physical Therapy
340 Magnolia Circle
Tyndall AFB, FL 32403
Phone: (850) 283-7019
Type: Location
PO BOX 80217
PHOENIX, AZ 850600217
Phone: (602) 385-2115
Fax: (480) 418-3323
Type: Mailing
325 MDG/PHYSICAL THERAPY
340 MAGNOLIA CIRCLE
TYNDALL AFB, FL 32403
Phone: (850) 283-7019
Type: Location
21250 W ROOSEVELT ST STE 106
BUCKEYE, AZ 853260313
Phone: (602) 648-5444
Fax: (602) 772-3801
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-11-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20251107002320 | I | Physical Therapist In Private Practice | AZ | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32403)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Orthopedic Surgery | AZ | |
| Physician Assistant | AZ | |
| Physical Therapist In Private Practice | AZ | |
| Orthopedic Surgery | UT | |
| Physician Assistant | AZ | |
| Physical Therapist In Private Practice | MT | |
| Physical Therapist In Private Practice | IL | |
| - | AZ | |
| - | AZ | |
| Physical Therapist In Private Practice | UT |
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