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

Richard P Jackson

Individual provider Physical Therapist · NPI 1053703215

Richard P Jackson is a Physical Therapist in Private Practice in Miami, Florida. Qualified in 2014, 12 years ago. Practices with Pinecrest Performance LLC, a 4-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
12
Licensed in
FL
In the registry since
2015
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Practice location Address checks out

9619 S Dixie Hwy
Miami, FL 33156-2804
Phone: (305) 722-0568
Fax: (305) 670-0899
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT30106 (FL)

Record details

NPI number1053703215
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 25, 2015
Last updated in NPPESJuly 25, 2022
Certification dateJuly 25, 2022
Mailing addressPo Box 331933, Miami, FL 33233-1933

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Pinecrest Performance Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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