Richard T Jackson LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

RICHARD T JACKSON LLC

Practice address

7 Southside Dr
Clifton Park, NY 12065-3887

Phone

(646) 957-7648

NPI assigned

Feb 21, 2020

Organization subpart

No

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

Authorized official

Name

Richard Jackson, MD

Title

Owner

Phone

(518) 709-0005

Specialties & licenses 1

Addresses

Other names 1

• Saratoga Headache Center Doing business as

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Richard T Jackson LLC

  • Neurology Physician
  • Latham, NY
  • NPI 1457961559
  NPPES parent name

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

{
    "created_epoch": "1582243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625702400000",
    "number": "1164055893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SOUTHSIDE DR",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653887",
            "telephone_number": "518-709-0005",
            "fax_number": "518-280-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 SOUTHSIDE DR",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653887",
            "telephone_number": "646-957-7648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Lear Jet Ln Ste 203",
            "address_purpose": "LOCATION",
            "city": "Latham",
            "state": "NY",
            "postal_code": "121102322",
            "country_code": "US",
            "telephone_number": "518-258-4033",
            "fax_number": "518-280-2275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RICHARD T JACKSON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-21",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-709-0005",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saratoga Headache Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelly Reynolds
• Jamie-Lyn Ricci, LMHC
• Riccio-Camardello NP in Psychiatry and NP in Family Health PLLC
• Alexandra P. Riccio, N.P.
• Richard J Herbold Chiropractor PC
• Casey Rieger
• Denise Riley, PMHNP
• Kristy Rinaldi
• Rite Aid of New York Inc
• Rite Aid of New York Inc

• Neurology Physician in Clifton Park, NY
• Providers in Clifton Park, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.