Individual provider Active NPI

Jason J Nackley, DC

  • Chiropractor
  • Clayton, NC
National Provider Identifier
1235341298
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
PENDING Issued in NY
Practice address
8838 US Highway 70 W
Suite 700
Clayton, NC 27520-4822
Phone
(919) 553-5505
Fax
(919) 553-9909
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X PENDING NY Primary

Addresses

Primary practice location

8838 US Highway 70 W
Suite 700
Clayton, NC 27520-4822

Mailing address

8838 US Highway 70 W
Suite 700
Clayton, NC 27520-4822
Phone (919) 553-5505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071213000617 NC Practitioner - Chiropractic 9436249406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1100 Pkwy Dr
Suite B
Goldsboro, NC 27534-3477
Phone (919) 751-1155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PENDINGNYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centered Chiropractic PA Chiropractor PastSince Jun 6, 2021 Accepting new patients
Clayton Chiropractic Center, P.a. Chiropractor PastSince Aug 1, 2001 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1235341298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8838 US HIGHWAY 70 W",
            "address_2": "SUITE 700",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275204822",
            "telephone_number": "919-553-5505",
            "fax_number": "919-553-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8838 US HIGHWAY 70 W",
            "address_2": "SUITE 700",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275204822",
            "telephone_number": "919-553-5505",
            "fax_number": "919-553-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NACKLEY",
        "first_name": "JASON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.