Christopher Jackson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

11711 Myrtle Ave
Richmond Hill, NY 11418-1751

Phone

(718) 847-9233

NPI assigned

Oct 15, 2025

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1760486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1003782095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1158 NUGENT AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117061340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11711 MYRTLE AVE",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114181751",
            "telephone_number": "718-847-9233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHRISTOPHER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-15",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Island Musculoskeletal Care, M.D., P.C.
• Ike Iwu
• Avraham Izrailov, DO
• Sharona Izrailova
• Avila T Jackson, DPM
• Darrick K Jagbandhansingh, PTA
• Sophia Mita Jagroop, M. D
• Aishvarya Jain
• Glenn Jakobsen, D.O.
• Geraldine Dela Jalon

• Clinical Social Worker in Richmond Hill, NY
• Providers in Richmond Hill, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.