Active NPI
Charley Dan Jackson, D.C.
- Chiropractor
- Covington, TN
National Provider Identifier
1437485760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2382
- Practice address
- 1618 Highway 51 S
Suite F
Covington, TN 38019-3237 - Phone
- (901) 476-7171
- NPI assigned
- Oct 21, 2009
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2382 | TN | Primary |
Addresses
Primary practice location
1618 Highway 51 S
Suite F
Covington, TN 38019-3237
Mailing address
31 Fieldcrest Dr
Jackson, TN 38305-3052
Phone (731) 925-0729
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 |
|---|---|---|---|
| 2382 | TN | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Durham Chiropractic | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Jackson, TN
- NPI 1548669872
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329782400000",
"number": "1437485760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 FIELDCREST DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383053052",
"telephone_number": "731-925-0729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1618 HIGHWAY 51 S",
"address_2": "SUITE F",
"city": "COVINGTON",
"state": "TN",
"postal_code": "380193237",
"telephone_number": "901-476-7171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CHARLEY",
"middle_name": "DAN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-10-21",
"last_updated": "2012-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TN",
"license": "2382",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covington, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.