Brian D. Jackson, DPM, LLC

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

436 Issued in TN

Legal business name

BRIAN D. JACKSON, DPM, LLC

Practice address

1215 Hatcher LN
Columbia, TN 38401-3531

Phone

(931) 380-0353

NPI assigned

Aug 15, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Brian Douglas Jackson, DPM

Title

President

Phone

(931) 380-0353

Specialties & licenses 1

Addresses

Other identifiers 6

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202256000000",
    "number": "1386836252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 HATCHER LN",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384013531",
            "telephone_number": "931-380-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 HATCHER LN",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384013531",
            "telephone_number": "931-380-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN D. JACKSON, DPM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-15",
        "last_updated": "2008-02-06",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "931-380-0353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "TN",
            "license": "436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DC1001",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3414014",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "3352132",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2740069",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF TN",
            "identifier": "4042682",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480034585",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan L Breeden, APRN, MSN, CPNP-AC
• Elizabeth Brewer
• John Mark Brewer, MD
• Ronald Brewer
• William Wesley Brewer, M.D.
• Brian Fann PLLC
• Laquitta Nicole Bright, OTR/L
• Laurence T Britt Jr., MD
• Elena Patricia Brizuela
• Carol Broadway, MD

• Foot Surgery Podiatrist in Columbia, TN
• Providers in Columbia, TN by specialty
• Foot Surgery Podiatrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; 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.