Timothy J Jackson, D.C., FIAMA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

15249 Issued in CA

Practice address

5525 Dewey Dr
Suite 210
Fair Oaks, CA 95628-3129

Phone

(916) 966-8375

Fax

(916) 966-8348

NPI assigned

Oct 13, 2006

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)

Enrolled

State licenses

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114017951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 DEWEY DR STE 210",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283131",
            "telephone_number": "916-966-8375",
            "fax_number": "916-966-8348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 DEWEY DR",
            "address_2": "SUITE 210",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283129",
            "telephone_number": "916-966-8375",
            "fax_number": "916-966-8348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "D.C., FIAMA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "15249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilynn S. Irvine, PH.D., MFT
• Ishtleen K.Bhatia,M.D., Inc.
• Lisa Iwanyczko, LVN
• Faranak Fara Izadi, LCSW
• Suzanne Jackson, LVN
• Jeff Elliot Jacobson
• James R. Musser, DDS, Inc.
• Brian Dee Jenkins, D.C.
• Jenna Vivaldi Therapy
• Jerida Lane Residential Care

• Chiropractor in Fair Oaks, CA
• Providers in Fair Oaks, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.