Aaron Jackson, DO, DPT

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

OT021545 Issued in PA

Practice address

4170 City Ave
Philadelphia, PA 19131-1610

Phone

(804) 543-6039

NPI assigned

Mar 30, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1154716934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4170 CITY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311610",
            "telephone_number": "804-543-6039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4170 CITY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311610",
            "telephone_number": "804-543-6039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "DO, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-30",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "23052009002",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "OT021545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackson and Associates Inc
• Aja Jackson Devose, D.O.
• Tracy P Jackson-Bunn, RN
• Maya Jackson-Gibson
• A'Taja Jackson
• Aaron Jackson
• Alyce Jackson, PH.D.
• Amanda Emily Jackson, C.R.N.P
• Andrea Arnita Jackson, CRNP
• Andrea L Jackson, CRNP

• Orthopaedic Surgery Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Orthopaedic Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.