Active NPI
Kristi Kay Jackson, D.C.
- Chiropractor
- Corunna, MI
National Provider Identifier
1346338696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- KB007405
- Practice address
- 227 N Shiawassee St
Corunna, MI 48817-1437 - Phone
- (989) 743-3515
- NPI assigned
- Oct 11, 2006
- Last updated
- Jun 12, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | KB007405 | MI | Primary |
Addresses
Primary practice location
227 N Shiawassee St
Corunna, MI 48817-1437
Mailing address
PO Box 17
Corunna, MI 48817-0017
Phone (989) 743-3515
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 950G850200 | Other | MI | BCBSM |
| 350051626 | Other | MI | RAILROAD MEDICARE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KB007405 | MI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434067200000",
"number": "1346338696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 17",
"city": "CORUNNA",
"state": "MI",
"postal_code": "488170017",
"telephone_number": "989-743-3515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "227 N SHIAWASSEE ST",
"city": "CORUNNA",
"state": "MI",
"postal_code": "488171437",
"telephone_number": "989-743-3515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "KRISTI",
"middle_name": "KAY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2015-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "KB007405",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "950G850200",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "350051626",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Corunna, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.