Illeana Jackson, LMT/MLD
NPI 1790636777 · Massage Therapist · Fayetteville, NC
Illeana Jackson, LMT/MLD is a Massage Therapist provider in Fayetteville, NC (NPI 1790636777).
Provider details
- NPI number
- 1790636777
- Entity type
- Individual
- Primary specialty
- Massage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- LMT/MLD
- Sex
- Female
- Sole proprietor
- Yes
- License
- 17654 (NC)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2026-02-05
- Last updated
- 2026-02-05
- Certified
- 2026-02-05
Frequently asked questions
- What is Illeana Jackson's NPI number?
- Illeana Jackson's National Provider Identifier (NPI) is 1790636777, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Illeana Jackson's specialty?
- Illeana Jackson is listed in the NPPES registry with a primary specialty of Massage Therapist (Respiratory, Developmental, Rehabilitative and Restorative Service Providers).
- Where is Illeana Jackson located?
- Illeana Jackson's practice location on file with NPPES is 6682 Vaughn Rd, Fayetteville, NC 28304-6009.
- What is Illeana Jackson's phone number?
- The practice phone number listed in the NPPES registry for Illeana Jackson is (910) 885-5396.
- Is Illeana Jackson's NPI active?
- Yes — Illeana Jackson's NPI (1790636777) is active in the NPPES registry as of the last update on 2026-02-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.