Individual provider Active NPI

Adam B Jackson, PHARM.D.

  • General Practice Physician
  • Denver, CO
National Provider Identifier
1306973375
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
15694 Issued in CO
Practice address
2045 Franklin St
Department of Infectious Diseases
Denver, CO 80205-5437
Phone
(303) 861-3471
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 15694 CO Primary

Addresses

Primary practice location

2045 Franklin St
Department of Infectious Diseases
Denver, CO 80205-5437

Mailing address

2045 Franklin St
Department of Infectious Diseases
Denver, CO 80205-5437
Phone (303) 861-3471

Other identifiers 1

IdentifierTypeStateIssuer
011378OtherKAISER-COMMERCIAL NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
15694COMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306973375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 FRANKLIN ST",
            "address_2": "DEPARTMENT OF INFECTIOUS DISEASES",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802055437",
            "telephone_number": "303-861-3471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 FRANKLIN ST",
            "address_2": "DEPARTMENT OF INFECTIOUS DISEASES",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802055437",
            "telephone_number": "303-861-3471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ADAM",
        "middle_name": "B",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CO",
            "license": "15694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER-COMMERCIAL NUMBER",
            "identifier": "011378",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.