Individual provider Active NPI

Alexandra L Jackson, DC

  • Chiropractor
  • Winooski, VT
National Provider Identifier
1487158044
Registry record updated Mar 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
006.0134122 Issued in VT
Practice address
20 W Canal St Apt 221
Winooski, VT 05404-2133
Phone
(949) 940-6468
NPI assigned
Mar 20, 2018
Last updated
Mar 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 006.0134122 VT Primary

Addresses

Primary practice location

20 W Canal St Apt 221
Winooski, VT 05404-2133

Mailing address

20 W Canal St Apt 221
Winooski, VT 05404-2133
Phone (949) 940-6468

Other practice location 1

185 Tilley Dr
South Burlington, VT 05403-4484
Phone (802) 879-1703

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maitri Health Care for Women PC CurrentSince Apr 1, 2018 Accepting new patients

Locations

185 Tilley Dr
South Burlington, VT 05403
Phone (802) 862-7338

185 Tilley Dr
Ste 57
South Burlington, VT 05403
Phone (802) 233-6692

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACAHCA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1487158044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 W CANAL ST APT 221",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "054042133",
            "telephone_number": "949-940-6468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W CANAL ST APT 221",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "054042133",
            "telephone_number": "949-940-6468"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "185 Tilley Dr",
            "address_purpose": "LOCATION",
            "city": "South Burlington",
            "state": "VT",
            "postal_code": "054034484",
            "country_code": "US",
            "telephone_number": "802-879-1703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ALEXANDRA",
        "middle_name": "L",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VT",
            "license": "006.0134122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winooski, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; 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.