Jackson Chiropractic Clinic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3241 Issued in OK

Legal business name

JACKSON CHIROPRACTIC CLINIC PC

Practice address

3801 S Boulevard St
Edmond, OK 73013-5479

Phone

(405) 330-6655

Fax

(405) 340-3531

NPI assigned

Jan 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Troy W Jackson, D.CNPI 1295779841

Title

President

Phone

(405) 330-6655

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: drj@jccp0003.direct.chirotouch.md

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Troy Wayne Jackson, D.C.

  • Chiropractor
  • Edmond, OK
  • NPI 1295779841
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073662680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 S BOULEVARD ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135479",
            "telephone_number": "405-330-6655",
            "fax_number": "405-340-3531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S BOULEVARD ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135479",
            "telephone_number": "405-330-6655",
            "fax_number": "405-340-3531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON CHIROPRACTIC CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-330-6655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Istishfa PLLC
• Betsy Ann Ittickathra, DO
• Ivedco, LLC
• Jordyn Ives, BCBA
• J & M Bowles LLC
• Jackson L. Sullivan D.D.S., P.C.
• Aleka Jaquaya Jackson
• Anthony Jackson
• Dominique Jackson
• Gwen D Jackson, RBT

• Chiropractor in Edmond, OK
• Providers in Edmond, OK by specialty
• Chiropractor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.