Dr Jerry S Jackson & Associates P a

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

145 Issued in KS

Legal business name

DR JERRY S JACKSON & ASSOCIATES P A

Practice address

113 Delaware St
Suite D
Leavenworth, KS 66048-2822

Phone

(913) 682-4335

Fax

(913) 682-2985

NPI assigned

Sep 16, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jerry Stephen Jackson, DPM

Title

President

Phone

(913) 682-4335

Specialties & licenses 1

Addresses

Other names 1

• Dr Jerry S Jackson and Associates P A Doing business as

Locations

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372204800000",
    "number": "1235235136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 DELAWARE ST",
            "address_2": "SUITE D",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660482822",
            "telephone_number": "913-682-4335",
            "fax_number": "913-682-2985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 DELAWARE ST",
            "address_2": "SUITE D",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660482822",
            "telephone_number": "913-682-4335",
            "fax_number": "913-682-2985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JERRY S JACKSON & ASSOCIATES P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2013-06-26",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "913-682-4335",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "KS",
            "license": "145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Jerry S Jackson and Associates P A",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle Dorsey
• Patricia Ann Doty, RN, BSN
• Amy L. Douglass, RN, MSN
• Kylie L Dowell, PSY.D.
• Andrew Doyle
• Dr Martha L Hurley an Operating Division of Saint John Hospital
• Dr. Jon M Moore, an Operating Division of Saint John Hospital
• Laura Drinkard, M.S., LMFT
• DRS Price Young Odle & Horsch PA
• Sharon Ann Dumlao

• Podiatric Clinic/Center in Leavenworth, KS
• Providers in Leavenworth, KS by specialty
• Podiatric Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; 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.