Ronald Evans Jackson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4675 Issued in TX

Practice address

715 Hill Country Dr Ste 5
Kerrville, TX 78028-5965

Phone

(830) 896-9633

Fax

(830) 896-9644

NPI assigned

Apr 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1988

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Jackson Clinic of Chiropractic, Inc.

  • Chiropractor
  • Kerrville, TX
  • NPI 1629556899
  Medicare reassignment

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1285857680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 HILL COUNTRY DR STE 5",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285965",
            "telephone_number": "830-896-9633",
            "fax_number": "830-896-9644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 HILL COUNTRY DR STE 5",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285965",
            "telephone_number": "830-896-9633",
            "fax_number": "830-896-9644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "RONALD",
        "middle_name": "EVANS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER ID",
            "identifier": "601885",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• J M Barnett MD PA
• Jackson Clinic of Chiropractic, Inc.
• Camilla Vawn Jackson, LMFT, LPC
• Cynthia Lynn Jackson, PT
• Devin Nicole Jackson
• Jennifer A Jaeger, LPC
• Deborah A. Jalbert, P.A.
• Jeanette L Masek MD PLLC
• Macalah Cortnee Jenschke
• Sarah Ruth Jerome, APRN

• Chiropractor in Kerrville, TX
• Providers in Kerrville, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.