A Living Chance Clinical Trials, Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

A LIVING CHANCE CLINICAL TRIALS, INC

Practice address

41593 Winchester Rd
Temecula, CA 92590-4860

Phone

(919) 308-1562

NPI assigned

Nov 29, 2018

Last updated

Dec 6, 2018By 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

Woody H Jackson, MDNPI 1073587598

Title

Owner

Phone

(919) 308-1562

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Woody H Jackson, MD

  • Family Medicine Physician
  • Wilmington, NC
  • NPI 1073587598
  Authorized official Same address or phone

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544054400000",
    "number": "1134699333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925640775",
            "telephone_number": "919-308-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41593 WINCHESTER RD",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925904860",
            "telephone_number": "919-308-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A LIVING CHANCE CLINICAL TRIALS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-29",
        "last_updated": "2018-12-06",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "WOODY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-308-1562",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Temecula, CA
• Providers in Temecula, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; 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.