Jackson Family Clinic, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

JACKSON FAMILY CLINIC, INC

Practice address

545 Broadridge
Jackson, MO 63755

Phone

(573) 243-8408

Fax

(573) 243-0445

NPI assigned

Mar 19, 2007

Last updated

Apr 29, 2008By 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

Dr. Kennett D Asher, DONPI 1073507315

Title

Owner

Phone

(573) 243-8408

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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.

• Kennett D Asher Jr., D. O.

  • Family Medicine Physician
  • Bloomfield, MO
  • NPI 1073507315
  NPD Authorized official

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1205950961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 BROADRIDGE",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "63755",
            "telephone_number": "573-243-8408",
            "fax_number": "573-243-0445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 BROADRIDGE",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "63755",
            "telephone_number": "573-243-8408",
            "fax_number": "573-243-0445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON FAMILY CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "ASHER",
        "authorized_official_first_name": "KENNETT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-243-8408",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "505190207",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CO9028",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah McKenzie Hutson, M.A., CFY-SLP
• Christina Renee Ivy
• J.U.S.T. Orthotics
• Jackson Dental
• Jackson Dental, LLC
• Jackson Manor Healthcare, LLC (Jackson Manor)
• Jackson Medical Center PC
• Jackson Pharmacy Inc (Medicenter Pharmacy)
• Jackson Pharmacy Inc (MediCenter Pharmacy)
• Jackson Physical Therapy & Rehabilitation, Inc.

• Family Medicine Physician in Jackson, MO
• Providers in Jackson, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.