Jackson Healthcare LLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

Legal business name

JACKSON HEALTHCARE LLC

Practice address

12409 W Indian School Rd
Suite #B210
Avondaale, AZ 85392

Phone

(623) 935-9920

NPI assigned

Feb 4, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Morgan, DC

Title

Owner

Phone

(623) 935-9920

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William J Jackson, MD

  • Family Medicine Physician
  • Shelbyville, KY
  • NPI 1447288709
  NPD (past)

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

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423008000000",
    "number": "1417347055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11180",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "85392",
            "telephone_number": "480-264-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12409 W INDIAN SCHOOL RD",
            "address_2": "SUITE #B210",
            "city": "AVONDAALE",
            "state": "AZ",
            "postal_code": "85392",
            "telephone_number": "623-935-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-04",
        "last_updated": "2015-02-04",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-935-9920",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.

Verify at the official NPI Registry.