Jackson Media Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

JACKSON MEDIA INC

Practice address

4210 27TH St
Long Island City, NY 11101-5087

Phone

(209) 432-5576

Fax

(209) 432-5590

NPI assigned

Oct 12, 2023

Last updated

Oct 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wesley Jackson

Title

Ceo

Phone

(916) 604-4793

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1114708260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 27TH ST",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111015087",
            "telephone_number": "209-432-5576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 27TH ST",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111015087",
            "telephone_number": "209-432-5576",
            "fax_number": "209-432-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON MEDIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-604-4793"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Iwule
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• Jenebu Jabbi
• Madamou Jabbie
• Jerreyll Travis Jackson, MD
• Jincy Jacob
• Marie Fritza Jacques
• Pablo Jaes, M.D.
• Komal Jaikaran

• Durable Medical Equipment & Medical Supplies in Long Island City, NY
• Providers in Long Island City, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.