Individual provider Active NPI

Adrian P Jackson, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Overland Park, KS
National Provider Identifier
1114985355
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
04-31121 Issued in KS
Practice address
7840 W 165TH St Ste 280
Overland Park, KS 66223-3022
Phone
(913) 322-2700
Fax
(913) 322-7890
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 04-31121 KS Primary

Addresses

Primary practice location

7840 W 165TH St Ste 280
Overland Park, KS 66223-3022

Mailing address

7900 College Blvd Ste 137
Overland Park, KS 66210-2194
Phone (913) 322-2700

Other practice location 1

23401 Prairie Star Pkwy Bldg B
Lenexa, KS 66227-7268
Phone (913) 322-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-31121KSMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Spine Care, P.a. Orthopaedic Surgery of the Spine CurrentSince Mar 20, 2022 Accepting new patients

Locations

7840 W 165th St
Ste 280
Overland Park, KS 66223
Phone (913) 381-0622

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1114985355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 COLLEGE BLVD STE 137",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102194",
            "telephone_number": "913-322-2700",
            "fax_number": "913-322-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7840 W 165TH ST STE 280",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662233022",
            "telephone_number": "913-322-2700",
            "fax_number": "913-322-7890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23401 Prairie Star Pkwy Bldg B",
            "address_purpose": "LOCATION",
            "city": "Lenexa",
            "state": "KS",
            "postal_code": "662277268",
            "country_code": "US",
            "telephone_number": "913-322-2700",
            "fax_number": "913-322-7890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ADRIAN",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "KS",
            "license": "04-31121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; 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.