DANA JACKSON – Physical Therapist, NPI 1174530638

DANA JACKSON is a healthcare provider. based in Poulsbo, Washington. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. PT00007115 (WA). The NPI Number for DANA JACKSON is 1174530638

Main info

Female
30 Years Of Experience
Accepts Medicare Assignment
Name
DANA JACKSON
NPI
1174530638
Phone
Not provided
Address
19319 7TH AVE NE STE 100
Enumeration Date
1 August 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3607921015
Graduation Year
1996 (30 years ago)
PAC ID
5092757062
Group Practice PAC ID
6507762333
Professional Enrollment ID
I20050531000984
Address ID
WA983104202BR2500XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

3,527 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WA

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Provider Addresses for DANA JACKSON

  • 7th Avenue Northeast, Poulsbo, Kitsap County, Washington, 98370, United States

    POULSBO, WA 983707442

    Phone:

    Type: Mailing

  • Cherry Avenue, Sheridan Park, Bremerton, Kitsap County, Washington, 98310, United States

    BREMERTON, WA 983104202

    Phone: (360) 792-1015

    Fax: (360) 792-0964

    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: 2005-05-31

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050531000984IPhysical Therapist In Private PracticeWATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97140Therapy procedure using manual technique, each 15 minutes33525$0
97530Therapy procedure using functional activities30135$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes24826$0
97162Evaluation for physical therapy, typically 30 minutes2828$0
View full utilization report →

Insurance plans in this area (ZIP 98370)

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Provider's Procedures

DANA JACKSON performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYWA97001Physical therapy evaluation3939
PHYSICAL THERAPYWA97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes43655

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6507762333View full group profile
NameSpecialtyState
-VA
Physical Therapist In Private PracticeWA
-WA
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA
-WA
Physical Therapist In Private PracticeCA
Occupational Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA
-WA

Reviews

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Frequently asked questions

Is DANA JACKSON listed with a National Provider Identifier?
Yes — DANA JACKSON has NPI 1174530638 on file in the registry.
Is there an active status for DANA JACKSON?
For scheduling context, DANA JACKSON is shown as active in the registry.
What area of care is associated with DANA JACKSON?
DANA JACKSON's record emphasizes Physical Therapist. Clinical services aligned with this taxonomy classification.
What locale is associated with DANA JACKSON?
Directory geography for DANA JACKSON centers on Poulsbo, Washington.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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