Active NPI
Christopher Michael Jackson, PCC
- Health & Wellness Coach
- Stamford, CT
National Provider Identifier
1396547642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health & Wellness Coach
- Practice address
- 44 Cerretta St Apt 8
Stamford, CT 06907-1819 - Phone
- (914) 426-4532
- NPI assigned
- Mar 26, 2025
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Health & Wellness Coach | 171400000X | Primary |
Addresses
Primary practice location
44 Cerretta St Apt 8
Stamford, CT 06907-1819
Mailing address
44 Cerretta St Apt 8
Stamford, CT 06907-1819
Phone (914) 426-4532
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009864864I | Other | NY | INTERNATIONAL COACHING FEDERATION |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742947200000",
"number": "1396547642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 CERRETTA ST APT 8",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069071819",
"telephone_number": "914-426-4532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 CERRETTA ST APT 8",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069071819",
"telephone_number": "914-426-4532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CHRISTOPHER",
"middle_name": "MICHAEL",
"credential": "PCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-03-26",
"last_updated": "2025-03-26",
"certification_date": "2025-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERNATIONAL COACHING FEDERATION",
"identifier": "009864864I",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stamford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.