Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jermie Micheal Jackson, LPTA

Individual provider Physical Therapy Assistant · NPI 1730056979

Jermie Micheal Jackson, LPTA is a Physical Therapy Assistant in Tupelo, Mississippi. Practices as a sole proprietor. Licensed in Mississippi.

Licensed in
MS
In the registry since
2025

Practice location Address checks out

1114 Commonwealth Blvd
Tupelo, MS 38804-9301
Phone: (662) 840-6366
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PT-6667 (MS)

Record details

NPI number1730056979
Entity typeIndividual (Type 1)
GenderMale
Credentials LPTA
Sole proprietorYes
NPI enumeratedOctober 22, 2025
Last updated in NPPESOctober 22, 2025
Certification dateOctober 22, 2025

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