Active NPI
Christian Jackson, LMSW
- Social Worker
- Mexico, MO
National Provider Identifier
1366142168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 2024027413
- Practice address
- 340 Kelley Pkwy
Mexico, MO 65265-3811 - Phone
- (573) 582-1234
- Fax
- (573) 582-1212
- NPI assigned
- Mar 9, 2023
- Last updated
- Jun 30, 2026
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 2024027413 | MO | Primary |
Addresses
Primary practice location
340 Kelley Pkwy
Mexico, MO 65265-3811
Mailing address
340 Kelley Pkwy
Mexico, MO 65265-3811
Phone (573) 582-1234
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
340 Kelley Pkwy
Mexico, MO 65265-3811
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782777600000",
"number": "1366142168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 KELLEY PKWY",
"city": "MEXICO",
"state": "MO",
"postal_code": "652653811",
"telephone_number": "573-582-1234",
"fax_number": "573-582-1212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 KELLEY PKWY",
"city": "MEXICO",
"state": "MO",
"postal_code": "652653811",
"telephone_number": "573-582-1234",
"fax_number": "573-582-1212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CHRISTIAN",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-09",
"last_updated": "2026-06-30",
"certification_date": "2026-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MO",
"license": "2024027413",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mexico, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.